Clapham House Accommodation Form

If you require to move in during the week then email me pnielsen@ne-ha.co.uk

A 43 week contract normally starts beginning of September, we are flexible with starting dates, but must be 43 weeks or longer. please email for these.

Please note: by signing below you are giving us consent to keep next of kin on file.

The North Eastern Trustees Ltd firmly believe that all sections of the community should have equal access to housing, irrespective of race, colour, nationality, ethnic and national origin, religious belief, disability or sexual orientation.

To ensure that this policy is effective, we would be grateful if you could complete the following form. This information is confidential and will only be used to check that our policy is working fairly. Your application for housing will not be affected if you do not wish to complete this questionnaire.

We may need to contact other agencies for information about you so that we can process your application. This could include Local Housing Offices, other Local Authorities, Housing Associations, Probation Service, Police, Benefit Agencies, HMRC, Immigration and Social Services. This information could aid your application.

I give the North Eastern YWCA Trustees Ltd consent to contact my present and/or former landlord, any of the above agencies and any other relevant agencies. I authorise them to disclose any information held by them for the purpose of dealing with my application for housing. I understand that any information given to the North Eastern YWCA Trustees Ltd will only be used by them in relation to may application for housing and will not be used for any other purpose or disclosed to any persons without my permission.

I agree to keep the North Eastern YWCA Trustees Ltd informed of any change to my circumstances.

All information will be treated in the strictest confidence and in accordance with the relevant Data Protection legislation. Please check that you have completed this form correctly, an incomplete or unsigned form will be returned to you.

We use your data for the following purposes:-

• To keep you safe by having knowledge of your medical conditions and Doctor contact.
• To have knowledge of your next of kin in case of emergency.
• To maintain our own accounts and records.
• To liaise with appropriate media

Storing your personal data:-

Your data is stored on a password secured, firewall and virus protected computer for as long as is necessary to comply with UK company law and Inland Revenue requirements.

DECLARATION, AUTHORITY TO SEEK INFORMATION & SIGNATURES:

I understand that if a licence is offered to me providing false information the North Eastern YWCA Trustees Limited reserves the right to investigate legal proceedings to recover possession of the property.

I confirm that I have no objection to the North Eastern YWCA Trustees Limited taking whatever steps are deemed necessary to verify the information contained in the application, or any other information subsequently given, in accordance with the relevant Data Protection legislation.

Please note: you have the right to check the accuracy of data. The data will be held 6 years on file in line with policy, then destroyed.

REMEMBER YOU MUST TELL US OF ANY CHANGE TO YOUR CIRCUMSTANCES