Contact Zetetick Housing - A Unique Charity

General Enquiry

Complaints or Compliments

Make a Referral

Details of Referrer

Please complete as much of the form as possible with as much information available. Note: * denotes mandatory responses.
1. Name *
2. Local Authority *
3. Date *
1. Job Title *
2. Telephone *
3. Email *
Applicants Details
1. Applicants Name *
Street Address *
Address Line 2
1. City *
2. County
1. Post Code *
2. Email *
3. Telephone *
1. Date of birth *
2. Select Gender
3. National Insurance

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Applicants Representative

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Support Provider & Funding

Whilst Zetetick is a Charity, ALL nominations MUST be supported under contract with the Local Authority, either direct support with Zetetick Housing or by their approved nominated Care Provider for and on behalf of Zetetick Housing.
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Has Support Funding been approved? YesNo
(If No) Expected Date to present to funding panel
Please select and confirm the ZH approved nominated Care Provider
Please select and confirm the Local Authority Commissioning Provider
Please provide a brief history on any prior tenancy arrangements and/or issues i.e. arrears, ASB, other legal actions etc
Prior Tenancy Arrangements *
Reason for referral, including tenant and family expectations *

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Contact Zetetick Housing Charity