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Housing Application

Application Form for Housing & Support

HomeApplication Form for Housing & Support

Please enable JavaScript in your browser to complete this form.

Please answer all the questions as honestly as possible to enable us to help you as much as possible with your application for housing and support.

Who is filling in this form?

Checkboxes

You
Both you and someone else

1: About You

Personal Information

Date

Full Name *

First

Last

Email Address *

Phone Number *

Date of Birth

Gender

Any previous names you have been known by?

National Insurance Number

Nationality

Language Spoken

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Do you need an interpreter?

Yes
No

2: Supporting Organisation/ Referrer

If you are an organisation supporting this application, please complete the following section:

Name of Organisation *

Name Person Completing this Section *

First

Last

Relationship to applicant:

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone

Email *

Are you completing this whole form on behalf of the applicant?

Yes
No

Please tell us in what capacity and for how long you have known the applicant?

2: Supporting Organisation (continued)

Are there any other support services working with you at the moment?

Please tell us what you think the applicant's housing and support needs are:

Signature (person completing this section)

Clear Signature

For the applicant: Is it ok for us to contact this person/organisation?

Yes
No

3: Homelessness

Are you homeless or at risk of homelessness or living in unsuitable accommodation at the moment? Please give us details:

Which areas do you think you need support to enable you to keep your tenancy, keep safe and lead the life you want: please tick as appropriate:

Motivation and taking responsibility
Selfcare and living skills
Managing money
Social networks and relationships
Drug or alcohol use
Physical health
Emotional and mental health
Meaningful use of time
Managing tenancy and accommodation
Offending

Please explain why you need support in these areas?

Do you have any medical conditions or disabilities you'd like to let us know about?

Have you had your own tenancy before?

Yes
No

Please tick any or all boxes – which type of accommodation would be most suitable:

A shared house with other tenants
My own place living on my own
Ground floor
First floor or above
Do you need a: Bath Shower Both

Please list any accessibility requirements:

Are there any areas you need to avoid?

Please list any local connections you have to the area in which you want to live (family, friends etc):

Safety/ Risk Assessment

Verbal aggression?

Yes
No

Date

Please give a brief description of situation:

Domestic violence?

Yes
No

Date

Please give a brief description of situation:

Physical Abuse?

Yes
No

Date

Please give a brief description of situation:

Mental Health Disorders?

Yes
No

Date

Please give a brief description of situation:

Drug/ Alcohol Abuse?

Yes
No

Date (copy)

Please give a brief description of situation:

Trafficking and Exploitation?

Yes
No

Date

Please give a brief description of situation:

Offending?

Yes
No

Date

Please give a brief description of situation: (copy)

Financial Abuse?

Yes
No

Date

Please give a brief description of situation:

Any other type of abuse?

Yes
No

Date (copy)

Please give a brief description of situation: (copy)

Affordability

This is to help work out if you can afford our accommodation:

Are you in employment, education or training?

What benefit or income to you receive, please give us as much information as possible to help us process your application?

Is there anything else you would like to tell us to support your application?

Accessibility

Are there any issues we need to consider if we invite you to a face-to-face assessment? (e.g. wheelchair user/visual or hearing impairment etc)

Please sign to say that you agree that this information is true and accurate:

Full name of applicant:

Single Line Text

Date:

Single Line Text (copy)

Signature

Clear Signature

Thank you for your application.

Application process

After submitting a housing application to Oak Care Home, the team will review your details, conduct a personal assessment, and develop a tailored care plan. Healthcare professionals will evaluate and finalise the plan with your feedback. They will support your transition and regularly update the plan to meet your evolving needs, ensuring personalised and comprehensive care.

About The Hope Project

The Hope Project is a beacon of hope and support for individuals facing homelessness in our community. Founded with the mission to provide compassionate assistance and empower individuals to rebuild their lives, The Hope Project offers a comprehensive range of services. These include temporary shelter, access to basic necessities such as food and clothing, counseling services, and assistance with job training and placement.

At the heart of The Hope Project is a commitment to restoring dignity and fostering independence. Through personalized care plans and a supportive environment, we strive to address the immediate needs of those experiencing homelessness while equipping them with the tools and resources necessary for long-term stability.

With the collaboration of dedicated volunteers and community partners, The Hope Project aims to create positive change and break the cycle of homelessness. Our ultimate goal is to inspire hope, empower individuals, and make a lasting impact on our community.

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Address: 318 High Street, Enfield , London EN3 4HF
Phone: 07983000814
Email: enquiry@oakcarehomesupport.co.uk

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