Prior to commencing this form, please ensure you have read the Accommodation Eligibility Criteria in full 

Personal Details

Contact Details

Next of Kin

Doctor Information

Residential Status

Property Requirements


What other payments do you currently make? Please provide average monthly amounts in £ for all those that apply. Enter zero for those that do not apply.

Non-work related Income

Please confirm how much of the following non-work related income (per month) and savings you have. Enter zero for those that do not apply.

Rehabilitation of offenders Act 1974

Additional Notes 

Equality & Diversity Monitoring

Please help us to check and ensure that we are making our independent living accommodation schemes available to all eligible applicants by answering the following questions.

Ethnicity Monitoring

By submitting your application, you are agreeing to the following terms:

1.        I declare that the statements made by me in this accommodation application are true to the best of my knowledge and I agree to advise Pathways of any changes in respect to the information provided in this application as soon as they occur.

I understand that if I were found to have falsified information and therefore obtained housing by deception I may be prosecuted and may lose my home.

I agree that if I am offered accommodation, I shall occupy it as a beneficiary of the Charity and not as a tenant.

Any monthly or weekly sum I pay will be regarded as a maintenance contribution and not rent.

2.        I agree with the processing of my data by Pathways Housing

Processing of your data is necessary in order to progress your request. The supplied data relating to you shall be kept for no longer than is necessary for the purposes for which it is being processed.

 3.  I agree to all data I submit being stored online in compliance with Arthur Online's GDPR and Privacy policies.