Application to Become a Beneficiary of the Foundation

Thank you for your interest in applying for housing with our Foundation.
As a small charity we have around 100 flats available for beneficiaries who meet the criteria set out in the governing document and as there is not a high turnover of residents there can at times be a wait for a suitable flat to become available for new applicants.

The Trustees require that all applicants complete the application form as fully as possible in order that they have as detailed a picture of an individual’s circumstances as possible in order to be able to consider them for an initial interview.

Application

Important Information

The information which you provide in the form will assist the Trustees of the Foundation in assessing your housing need and qualification potentially to be appointed as a beneficiary to be provided with charitable housing by the Foundation.

Applicants must have served in HM Armed Forces (including the Reserves) or the British Mercantile Marine and now have an infirmity or long-term health condition which has been recently assessed and documented by a suitably qualified medical professional. Relevant service may have been at any time prior to the submission of your application. Those who are successfully appointed by Trustees as beneficiaries are known as “Guests” of the Foundation and can then be allocated to a Foundation flat on the Balham Estate. Guests occupy their flat under a “Licence to Occupy” granted by the Trustees and are not tenants. Therefore Guests do not pay a rent for their flat but instead pay a Weekly Maintenance Charge (WMC) to cover the costs of the accommodation. Guests are responsible for their own Council Tax and Utility Bills.

The application form needs to provide Trustees with as much relevant background information as possible so that they have the opportunity to understand your current situation and be able to make a fair assessment of your need for housing. Therefore, you should try and complete all sections in as much detail as possible and continue on an additional page if there is insufficient space. If there is any information you are unable to supply please explain why and do not leave blank spaces. Please contact us if you require any guidance.

There is also a requirement of the Foundation that an applicant should be able to demonstrate that they are of good moral character. It is expected that applicants and any co-occupiers who may live in a flat with them are able to satisfy the character requirements for the term of their occupation of a Foundation flat. It is most important that you declare if you or a potential co-occupier have any criminal convictions and provide details unless they are considered as spent. This will not necessarily exclude you from being considered as an applicant but Trustees do need to be fully informed as part of the decision-making process.

All information provided by you as part of the application process will be treated as confidential. If we need to contact anyone for additional information we will ask for your permission before we do this.

Your completed application form (together with photocopies of the supporting documentation) should be posted to the address at the top of this page. Please do not send original documents or use a recorded delivery service as there is not always someone in the office to sign for post and collection from the sorting office only causes delays.

I confirm I have read the important information above...

Yes

Documents

The form should be accompanied by our supporting documentation which details:

Record of Service in HM Forces or British Mercantile Marine.
Details of Infirmity or long-term medical condition.
Details of current medical treatment or supervision.
Proof of entitlement to reside in the UK.

I confirm that I have all of the documents required...

Yes

Application Type

Select Type

Online Application

Postal Application

Download Postal Application PDF

Online Application

1. Personal Details

1.1 You & Your Family

Name(Required)

First Last

Date of Birth(Required)

Nationality(Required)

If you are not a British citizen automatically entitled to live in the UK, please enclose evidence of permission to reside in the UK

Drop files here or

Accepted file types: doc, docx, pdf, jpg, png, Max. file size: 50 MB, Max. files: 5.

Current Address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Why are you leaving this address?(Required)

Home Phone

Work Phone

Relationship Status

Spouse/Partner

Name

First Last

Date of Birth

Other family who live(s) with you

Please include full names and relationship to you.

Name

First Last

Relationship to you

Name

First Last

Relationship to you

Name

First Last

Relationship to you

Next of Kin

Name

First Last

Relationship to you

Phone

Address

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

1.2 Service Record

Service Branch(Required)

Royal Navy

Army (Corps/Regiment)

Royal Air Force

Mercantile Marine

Service Number or Merchant Navy Discharge Book Number(Required)

Rank(Required)

Junior Rank (OR 1-3)

Junior NCO (OR 4-6)

Senior NCO (OR 7-9)

Junior Officer (OF 1-2)

Senior Officer (OF 3-5)

General (OF 6-10)

Date Enlisted(Required)

Date Discharged(Required)

Reason for Discharge(Required)

Attach a copy extract of your discharge document, your Merchant Navy Discharge Book or written evidence in support of your service record(Required)

Drop files here or

Accepted file types: doc, docx, pdf, jpg, png, Max. file size: 50 MB, Max. files: 5.

Your discharge record is a minimum requirement.

1.3 Current Employment

Please give details of your current employment, if any, saying where you work, what you do and for how long you have been in your current occupation.

Emplyoyment basis

Full time

Part time

Who is your employer?

If you are not employed are you in receipt of state benefits? (Universal Credit)

Yes

1.4 Infirmity

Please give details of your infirmity or medical condition and current medical treatment (if any).

Do you use any aid - such as wheelchair/mobility scooter?

How long is your infirmity/medical condition expected to last?

If you are not self-caring, please state the extent to which assistance is needed

Are you able to look after your own home?

Please confirm that you would be capable of independent living and self-care in a Foundation flat as the Foundation is unable to provide care/support. However you may access a range of support from external organisations if required, for health matters.

Please provide details for the Doctor/Medical Practice you are registered with.

Would you agree to us contacting the medical professional for more information if required?

Yes

Please upload copy medical evidence in confirmation of your infirmity or medical condition

Drop files here or

Accepted file types: doc, docx, pdf, jpg, png, Max. file size: 50 MB, Max. files: 5.

Please state whether your infirmity or medical condition arises from your military (or Mercantile Marine) service.

If you are in receipt of a War Pension or Armed Forces Compensation Scheme payment please provide details of the award. You should include details of the degree of disability and any related documentation.

1.5 Present Accommodation

Do you occupy a...(Required)

Please state other accommodation

How long have you lived here?

Are you a tenant or an owner?

Tenant

Owner

How many rooms do you occupy?

Do you share a kitchen and/or a bathroom?

Do you have either sole or joint use of any other accommodation?

What are your reasons for wanting to move?

Who do you expect would also live with you if you are accepted as a Resident?

What is their relationship to you?

1.6 CRIMINAL CONVICTIONS (In line with the Rehabilitations Act of 1974)

Do you have any unspent convictions under The Rehabilitation of Offenders Act 1974. If yes, please list them here. Applicants with spent convictions do not have to disclose them.

Date

Court

Offence

Sentence

Date

Court

Offence

Sentence

Date

Court

Offence

Sentence

1.7 Referral

Please state where or how you heard about the Foundation

2. Your Financial Circumstances

Knowledge of financial circumstances is to assist the Foundation in making a balanced judgement about the applicant’s need for housing. It is also to help identify any particular need for support to meet the costs and ordinary living expenses which a resident will incur. Responses given below are in confidence to the Foundation, its Managing Agents and Authorised Officers. You do not have to include your War/Disability Pension or AFCS in these details provided that you have included them in Part 1.3 above. They will not be included in our assessment of your financial eligibility for becoming a beneficiary of The Foundation.

2.1 Monthly Income

Your net take-home pay £/month

Include earnings & tax credits after tax and NI have been deducted

Partner net take-home pay £/month

Include earnings & tax credits after tax and NI have been deducted

Other net take-home pay £/month

Include earnings & tax credits after tax and NI have been deducted

Your Child Benefit £/month

Include any educational grants received.

Partner Child Benefit £/month

Include any educational grants received.

Other Child Benefit £/month

Include any educational grants received.

Your net occupational/service pension £/month

Partner net occupational/service pension £/month

Other net occupational/service pension £/month

Your Universal Credit £/month

Include state pension, pension credit, jobseekers allowance, disabled living / personal independent payment (PIP), allowance, attendance allowance & statutory sick pay but not housing benefit/local housing allowance.

Partner Universal Credit £/month

Other Universal Credit £/month

Your other income £/month

Partner other income £/month

Other income £/month

Your Child or Tax Credit £/month

Partner Child or Tax Credit £/month

Other Child or Tax Credit £/month

Your total monthly income

Partner total monthly income

Other total monthly income

2.2 Savings, investments and capital assets of you/your Partner

Value of all savings & investments

Include bank & building society accounts, savings deposits, Premium Bonds, shares and other securities.

Approximate value of capital assets

Include property but not household goods, furnishings or car

Approximate yearly income (if any) from savings & investments

2.3 Accommodation Charges

How much is your current monthly rent?

If you receive housing benefit/LHA please say how much, per month.

If you do not pay rent, please explain why

Are you behind with your rent? If yes, how much do you owe? Please provide details of any payment agreement you have made.

2.4 Loans

Do you have repayment agreements in force for loans made by any bank, authority, building society or other lender? If so, please state the balance owed and repayment term

Balance owed

Repayment term (years)

2.5 Debts

Do you have any unsecured debts to repay, such as credit card debts? If so, please state the balance owed.

Balance owed

2.6 Financial Commitments

Apart from domestic and living needs, are there any special commitments such as child support, alimony or regular medical costs? If so please give details below:

3. Notes

3.1 Enclosures. Before sending this form to the Foundation, please check that you have enclosed details of your service record and confirmation of your infirmity or medical condition.

3.2 Rent Arrears. Unless there are exceptional circumstances, applicants seeking to transfer from an existing rental arrangement with this, or any other, housing provider are expected to have an up-to-date rent position or have an agreement in force and operating satisfactorily for the repayment of any rent arrears.

3.3 False Statements If the Foundation discovers that any information on this form is false, it may not be able to appoint you as a Resident or it may have to take legal action to repossess any accommodation allocated to you.

4. Declaration

I declare that the statements and financial information given above are, as far as I know, correct. I will tell you immediately if there is any change in my situation and I give you permission to make any reasonable enquiries to confirm the details I have given.

I understand that if I knowingly provide inaccurate information or do not fully disclose details of my situation it may affect my appointment as a beneficiary of the charity and entitlement to the provision of housing.

Name(Required)

First Last

Date(Required)