Independent Living

Expression of Interest

Please complete the form below if you would like to express an interest in our independent living schemes.

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Connection to the Borough

If you are not currently a resident of Elmbridge, please explain your connection to the Borough.

Contact Telephone Number

Email Address

Date of birth

Do you have preference on accommodation?*

*Please note we cannot guarantee to offer the property of your choice. Decisions on allocations are based on need of all applicants and are subject to the Charity’s prevailing allocations policies. NO PETS ARE PERMITTED EXCEPT GOLDFISH AND SMALL CAGED BIRDS WITH THE EXCEPTION OF ASSISTANCE DOGS, SUBJECT TO CERTAIN CONDITIONS

Do you have any existing or developing support needs?

ALTERNATIVE CONTACT

If you are wanting to express an interest on behalf of someone - a parent, family member or friend please indicate this here by including your name and contact details as well.

Name

First Name

Last Name

Phone number

Relationship

Further Information

Health

It's useful for us to know if there are any mobility considerations or health implications when allocating flats so please tell us here of any information that would support your expression of interest.

Housing

It would be useful for us to understand your current housing situation and longer term needs to support your expression of interest in our accommodation for example are you living in unstable or temporary accommodation or has there been a relationship breakdown.

If you have been served notice on your current accommodation, please provide the date you need to vacate the property

It's helpful if you'd let us know where you heard about us - online, from a friend, referred by a local agency?

Immigration checks

Under the terms of the Immigration Act we are required to verify our residents right to occupy our properties. We can offer accommodation to those that fall into one of the following groups: A citizen of the UK, the European Economic Area or Switzerland A person with indefinite leave to remain or right of abode in the UK A person with a ‘time-limited’ leave to remain in the UK or a right to live in the UK A person with a ‘discretionary right to rent’ In order for us to ensure compliance with the Act we shall ask you to provide proof you are in one of the above categories, when you are offered a flat. We will seek appropriate documents such as a passport and we are required to keep copies for 1 year after your occupation with us ceases. The Charity will operate in accordance with the Government’s guidance which can be found at: https://www.gov.uk/government/publications/right-to-rent-landlords-code-of-practice/code-of-practice-on-illegal-immigrants-and-private-rented-accommodation#contents Please note if we cannot satisfactorily verify you are within one of the categories mentioned above, Walton Charity will not be able to offer you accommodation.

Ethnicity Monitoring

This information is used solely for monitoring purposes and will not be used to determine any allocations decision. Please tick the definition you believe applies to you.

Data Protection and sharing declaration

Walton Charity may need share your personal information with other organisations in order to verify information supplied or to assist you to receive a service. Walton Charity will share your personal information, without your consent to assist with the prevention or detection of crime. You have the right to request a copy of the personal information we hold about you. If you would like a copy of some or all of this please contact us on 01932 220242 or email Housing@waltoncharity.org.uk Walton Charity is a signatory to Surrey County Council’s Multi Agency Information Sharing Protocol full details of which can be found at: http://www.surreycc.gov.uk/social-care-and-health/surrey-children-and-young-peoples-partnership/information-sharing-for-professionals/information-sharing-protocol-for-multi-agency-staff Please note, if you are unable or unwilling to provide some or all of your personal information we have asked for, we may be unable to offer you assistance. The information you supply in this form will be used solely for the purposes of establishing your eligibility for accommodation and to assess your application. The information will be held on file until a) you have been accommodated by the charity or b) your application is rejected or c) you withdraw your application. In all cases and at the appropriate time, this form will be securely destroyed. I have read and understood the above and consent to Walton Charity using the personal information I have given them and sharing it as outlined above.

Signed

(please include an electronic signature if available)

Name

Date

Please click SUBMIT button below

Frequently asked questions:

Am I guaranteed an application will be accepted? No we cannot make that guarantee. Applications are assessed against criteria set out in the Charity’s Governing Document and Constitution and we can only accept applications which fit with those criteria. You would be notified or our decision in either case.

If an application is not successful will you keep the information I’ve supplied? We may keep some anonymised statistical information but nothing that would identify you. Having expressed an interest this information would be kept for up to twelve months before being destroyed.

Where can I get more information about my application? Contact our team on 01932 220242 or email housing@waltoncharity.org.uk

What form of occupation agreement do you grant? Walton Charity is an Almshouse charity provider and by law cannot grant tenancies but instead issues a Letter of Appointment. The Charity has a set of rules accompanying this letter to which both parties are required to abide by. Flats are occupied under licence.

Does this mean I would have no security of tenure? A Letter of Appointment does not grant the resident the same security of tenure rights as most tenants. The sanction to remove a resident from a property can only be taken by the Senior Leadership Team and only if a special resolution to that effect is passed. This can be because of behavioural issues or breaches of the terms of licence. We advise any prospective resident to seek legal advice or approach the Citizens Advice if they have concerns about the legal status of Almshouse residents.

Must staff call on me every day? Residents are offered a daily, weekly, or monthly call to fit with their lifestyle and support needs.