Papay Development Trust – Application form for housing
Please complete, sign and return:
- by post to PDT, Quarryhoose, Papa Westray KW17 2BU, or
- scan signed form and email to
to arrive by noon on Friday 11th November 2016.
Use extra sheets of paper if you require this to give sufficient detail to fully answer any question. For the application to be considered, the form must be completed fully, with the declaration signed (a scanned signature will be accepted).
Which PDT property do you wish to apply for: ……………………………………
Contact details
Your full name (inc. title):......
Your address (inc. post code):......
......
......
Email address(es):......
......
Telephone number(s):......
......
When did you move into your current address?:......
Details of main applicant (or applicants, in case of joint application)
Surname / Forenames / Date of birth / Sex (M/F) / National Insurance numberDetails of other household members
Surname / Forename / Date of birth / Sex (M/F) / Relationship to main applicant(s)Scoring System (see PDT Local Lettings Policy for context)
(i) Children for the Papa Westray Community School Roll
Do you have children of primary school age, who you intend to enrol in
Papa Westray Community School? Yes/No.
If applicable, how many child years[1] would they have at the school?......
(ii) Employment
Do you or a member of your household have an existing job offer in the island?
Yes/no (delete as appropriate). If yes, please give details:......
......
Do you or a member of your household have plans for employment in the island (locally or remotely through IT)? Yes/no (delete as appropriate).
If yes, please give details:......
......
......
(iii) Skills
What skills can you or members of your household offer, which might be judged to
correspond with an essential skill shortage in the island:......
......
......
Would you be willing and likely to be able to meet the requirements[2] of Highlands & Islands Fire & Rescue Service to serve the Papay community as a Retained Firefighter? Yes/no (delete as appropriate).
(iv) Existing connection with Papa Westray[3]
Are you currently or previously resident? Yes/no (delete as appropriate)
Do you have relatives currently resident? Yes/no (delete as appropriate)
Are you needed to provide support to an existing resident? Yes/no (delete as appropriate)
Factors related to potential exclusion from eligibility for a short-term tenancy
The size of the community and the geographic isolation mean that a full range of support systems are not available to households who may require help to sustain their tenancies. These factors also mean that the Papay community has a high sensitivity to anti-social behaviour. Please use additional paper to give full details if required in answer to any of the following questions.
- Do you or a member of your household have a history of violence or anti social behaviour? Yes/no (delete as appropriate)? If yes, please provide details.
- Have you or a member of your household received an anti social behaviour order (ASBO)? Yes/no (delete as appropriate)? If yes, please give details including the name of the person and the date ASBO was granted. If in rented accommodation at the time, please also give the name and address of the landlord at the time the order was served.
- Do you or a member of your household have an unspent conviction for drug dealing? Yes/no (delete as appropriate)? If yes, please provide details.
- Do you or a member of your household have a history of illegal drug use over the last 5 years? Yes/no (delete as appropriate)? If yes, please provide details.
- Do you or a member of your household have a history of aggression? Yes/no (delete as appropriate)? If yes, please provide details.
- Are you, or any member of your household, required to register with the Police for any reason, eg under the Sexual Offenders Act 2003? Yes/no (delete as appropriate)? If yes, please give details of the person registered.
- Do you or a member of your household have a history which is indicative of an inability or unwillingness to abide by reasonable tenancy conditions? Yes/no (delete as appropriate)? If yes, please provide details.
- Are you in rent arrears? Yes/no (delete as appropriate)? If yes, please provide details.
- Do you and everyone you want to live with have the right to reside in the UK? Yes/no (delete as appropriate). If ‘no’ please give details.
References
Please provide a referee for your application. If you have been in rented accommodation at any point over the last two years, this should be your last landlord. Otherwise, please provide details of an unrelated person, in a responsible position, who can provide a character reference for you.
Referee 1
Name (inc. title):......
Position (job or role): ......
Address (inc. post code):......
......
Email address:......
Telephone number(s): ......
How do they know you? ......
Declaration
This declaration must be read and signed by the main applicant (or main applicants, in the case of a joint application). If you fail to sign this, your application cannot be considered further.
I/we declare that to the best of my/our knowledge, the details entered on this application form are true, and provide a full and accurate answer to the questions posed.
I/we give Papay Development Trust permission to check the information given or obtain more details from any third party.
It is important that you answer all questions fully and honestly. If you knowingly give false information or make any significant omission, legal action may be taken to terminate your tenancy. In addition, you may be guilty of a criminal offence.
In the case of a joint application, both applicants must sign and date the declaration below.
I/we have read the information above and agree to the declaration:
Signature of applicant:......
Date of above signature:......
Signature of joint applicant:......
Date of above signature:......
Please note:
The information provided in this application will be treated in confidence and used solely by PDT for the purposes of its role as a registered private landlord.
Papay Development Trust – Scottish Charitable Incorporated Organisation number SC029585; Page 1 of 4
[1]for example, 3 child years could be represented by 1 child with 3 years left at Primary School or 2 children with 1 year and 2 years left.
[2]In summary, you must: be at least 18 years of age & eligible to work in the UK; be physically fit and active, in good health, with good vision & colour perception; be committed to serving your local community, and to personal development whilst on duty and in your own time; be available to attend your fire station promptly from home or place of work when on call; have the express consent of your employer to apply for the role (you would require their written consent to attend a two-week training course, weekly training sessions, and call-outs).
[3]Note that this is not a high-scoring element of the points system (see Lettings Policy), and applications are welcomed from those without an existing connection with Papa Westray.