Notes on how to complete this form can be downloaded here
It is important that the notes accompanying this application are read before the form is completed. If housing is required by two people currently living apart, then two seperate forms should be completed.
The completion of this application should not be taken as an indication that a house will eventually be offered to the applicant.
Date of birth
Address (including postcode)
National Insurance Number
Please give details of your previous addresses:
Previous Address 1
Reason for leaving
Previous Address 2
Previous Address 3
Previous Address 4
Previous Address 5
Previous Address 6
Previous Address 7
Previous Address 8
Previous Address 9
Previous Address 10
Previous Address 11
Previous Address 12
Previous Address 13
Previous Address 14
Previous Address 15
Previous Address 16
Previous Address 17
Previous Address 18
Previous Address 19
Previous Address 20
Previous Address 21
Previous Address 22
Previous Address 23
Previous Address 24
Previous Address 25
Please give details of previous landlords and addresses if applicable:
What type of house is it? (i.e. multi-storey, tenement, terraced etc)
How many bedrooms?
When did you move here?
Is the living room seperate from the kitchen?
Is there a fixed shower or bath?
Is the kitchen / bathroom or W.C. shared with non family member of another household?
Is the building subject of a Compulsory Purchase or Demolition Order?
Does the property has central heating?
Which of the following categories applies to you?
Name & address of current landlord
How many people live in the house, including yourself:
Who are they?
Relationship to you
What are the sleeping arrangements:
Details of persons to be rehoused with you and their present address if different to your own; If you have access to
a child please state how many nights they stay with you and provide written confirmation from an ex-partner or lawyer. Further evidence may be required at a later date.
Person to be rehoused with you 1
Relationship to yourself
Person to be rehoused with you 2
Person to be rehoused with you 3
Person to be rehoused with you 4
Person to be rehoused with you 5
Person to be rehoused with you 6
Person to be rehoused with you 7
Person to be rehoused with you 8
Person to be rehoused with you 9
Person to be rehoused with you 10
Person to be rehoused with you 11
Person to be rehoused with you 12
Person to be rehoused with you 13
Person to be rehoused with you 14
Person to be rehoused with you 15
Person to be rehoused with you 16
Person to be rehoused with you 17
Person to be rehoused with you 18
Person to be rehoused with you 19
Person to be rehoused with you 20
Person to be rehoused with you 21
Person to be rehoused with you 22
Person to be rehoused with you 23
Person to be rehoused with you 24
Person to be rehoused with you 25
Do you or any members of your household suffer from any medical condition or have a disability which makes your present accomodation unsuitable?
By this we mean a condition which as a long term and substantial effect on your ability to carry out normal day to day activities.
Please complete a medical form bearing in mind that we have tenement stock stating which floor level you would be comfortable with. You can complete this form on the website.
Have you ever had legal action taken against you for arrears of rent / mortage or anti social behaviour?
Please give details:
Have you or any member of your application been convicted relating to Sexual Offences or must register with the police under The Sexual Offences Act 2003?
Strict confidentiality of this information will be observed, although transfer of this information will be made to the council's designated officer, in charge of monitoring and liaison with the police.
Do you owe any arrears of rent / mortgage to your current or previous landlord or lender?
We recommend that you apply to South Lanarkshire Council for housing. Contact the Questions & Answers office to obtain a Homefinder application form: 0845 740 6080
Are you on the SLC homeless list?
Please provide a copy of your homeless letter
Are you, or is anyone else in your household, related to or otherwise connected with a member of the RCHA Management Committee or staff?
To assist us in pointing your application, please use the space below to provide any further details of why you require housing, in particular, any special circumstances which you feel should be considered when your application is being assessed?
We have houses in the Mill Road estate, Halfway, Central Cambuslang, The Circuit and outlying areas of Rutherglen, as well as our tenement stock in central Rutherglen.
As the turnover in some of these areas is very low, you may have to wait for a while if you are specifying a particular area.
Indicate below which areas you wish to be considered for:
Gypsy / Traveller
Any other white
Any other asian background
Any other black background
Arab, Arab Scottish or Arab British
Any other group
Please state how many people in your application have a Disability
Please select all that apply
The following declaration should be read carefully before signing
At least one piece of recent documentary evidence confirming your residence at the address you are applying from must be included with this application; This could be a photocopy of a benefit book, bank statement, or some recent mail. Further proof may be required at a later date.
Failure by you to produce this information will result in your application being returned.
I certify that the information given in this application is correct and complete, and I consent to the Association making such enquiries as may be necessary to confirm the information provided by me.
I agree to advise the Association of any change of circumstances which may affect this application. I understand that any false or misleading information, or information deliberately withheld, may result in the suspension or cancellation of my application, or any offer of tenancy being immediately withdrawn, or where a tenancy has been granted this may result in action being taken to terminate the tenancy.
Aspire Business Centre,
16 Farmeloan Road,
For tenant information call… 0141 647 4917
© Rutherglen and Cambuslang Housing Association 2018
Scottish Housing Regulator Registration No. 176. Registered with the Financial Services Authority (2029RS)
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A Charity Registered in Scotland No. SC041992