Call Us
Tel 0300 131 7300
Address
Islington & Shoreditch Housing Association (ISHA) 102 Blackstock Road London N4 2DR
Name *
Email *
Telephone *
Postcode *
0300 131 7300
Welcome to Islington and Shoreditch Housing Association
Finding a home
Please complete all fields of this form to not delay your registration. Should you have any problems, email our sales@isha.co.uk or call 020 7704 7388. Please confirm whether the application is a single application or joint * please select Single Joint What type of property are you interested in? * please select New build Pre-owned Which new build development(s) are interested in? * Prospect House, E17 One Fox Lane, N13 Hoxton House, N1 Electric Quarter, EN3 North Seven, N7 Name or address of the pre-owned home you are interested in What size(s) of property are you interested in? 1 bed 2 bed 3 bed 4 bed Where did you hear about ISHA? * please select Homes for Londoners Share to Buy Rightmove Other property website ISHA website Family/friend Site advertising board Other
Please confirm whether the application is a single application or joint * please select Single Joint What type of property are you interested in? * please select New build Pre-owned Which new build development(s) are interested in? * Prospect House, E17 One Fox Lane, N13 Hoxton House, N1 Electric Quarter, EN3 North Seven, N7 Name or address of the pre-owned home you are interested in What size(s) of property are you interested in? 1 bed 2 bed 3 bed 4 bed Where did you hear about ISHA? * please select Homes for Londoners Share to Buy Rightmove Other property website ISHA website Family/friend Site advertising board Other
What type of property are you interested in? * please select New build Pre-owned Which new build development(s) are interested in? * Prospect House, E17 One Fox Lane, N13 Hoxton House, N1 Electric Quarter, EN3 North Seven, N7 Name or address of the pre-owned home you are interested in What size(s) of property are you interested in? 1 bed 2 bed 3 bed 4 bed Where did you hear about ISHA? * please select Homes for Londoners Share to Buy Rightmove Other property website ISHA website Family/friend Site advertising board Other
Which new build development(s) are interested in? * Prospect House, E17 One Fox Lane, N13 Hoxton House, N1 Electric Quarter, EN3 North Seven, N7
Name or address of the pre-owned home you are interested in
What size(s) of property are you interested in? 1 bed 2 bed 3 bed 4 bed Where did you hear about ISHA? * please select Homes for Londoners Share to Buy Rightmove Other property website ISHA website Family/friend Site advertising board Other
1 bed 2 bed 3 bed 4 bed Where did you hear about ISHA? * please select Homes for Londoners Share to Buy Rightmove Other property website ISHA website Family/friend Site advertising board Other
2 bed 3 bed 4 bed Where did you hear about ISHA? * please select Homes for Londoners Share to Buy Rightmove Other property website ISHA website Family/friend Site advertising board Other
3 bed 4 bed Where did you hear about ISHA? * please select Homes for Londoners Share to Buy Rightmove Other property website ISHA website Family/friend Site advertising board Other
4 bed Where did you hear about ISHA? * please select Homes for Londoners Share to Buy Rightmove Other property website ISHA website Family/friend Site advertising board Other
Where did you hear about ISHA? * please select Homes for Londoners Share to Buy Rightmove Other property website ISHA website Family/friend Site advertising board Other
By signing this form I/we confirm that the information given is complete and correct to the best of my/our knowledge and I/we understand that: • If any of the information provided changes prior to the completion of a purchase, I/we will inform Islington & Shoreditch Housing Association immediately. • If I/we have a current ownership/financial interest in another property, I/we will be required to sell/legally relinquish this interest before any shared ownership purchase proceeds to contract. *
• If any of the information provided changes prior to the completion of a purchase, I/we will inform Islington & Shoreditch Housing Association immediately. • If I/we have a current ownership/financial interest in another property, I/we will be required to sell/legally relinquish this interest before any shared ownership purchase proceeds to contract. *
• If I/we have a current ownership/financial interest in another property, I/we will be required to sell/legally relinquish this interest before any shared ownership purchase proceeds to contract. *
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Personal details Title * please select Mrs Mr Ms Miss Dr First name * Surname * Date of Birth (dd/mm/yyyy) * Home Phone Mobile Phone * Email * Address * Borough * Postcode * What is your current residential status? * please select Renting Privately Living with Friends/Relatives Housing Association Tenant Local Authority Tenant Owner/occupier Other National Insurance number * How many children/other dependants do you have? * please select 0 1 2 3 4 or more What is your relationship to the other applicant? * please select Spouse Partner Son/daughter Sibling Friend none - single applicant Parent Carer Other Please confirm your nationality * please select British EU national Non EU national If EU national please specify country If Non EU national is evidence of indefinite leave to remain provided? please select Yes No Employment Please confirm your current employment status * please select employed self-employed temporary contract fixed contract unemployed Job Title * Employer name * Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Title * please select Mrs Mr Ms Miss Dr First name * Surname * Date of Birth (dd/mm/yyyy) * Home Phone Mobile Phone * Email * Address * Borough * Postcode * What is your current residential status? * please select Renting Privately Living with Friends/Relatives Housing Association Tenant Local Authority Tenant Owner/occupier Other National Insurance number * How many children/other dependants do you have? * please select 0 1 2 3 4 or more What is your relationship to the other applicant? * please select Spouse Partner Son/daughter Sibling Friend none - single applicant Parent Carer Other Please confirm your nationality * please select British EU national Non EU national If EU national please specify country If Non EU national is evidence of indefinite leave to remain provided? please select Yes No Employment Please confirm your current employment status * please select employed self-employed temporary contract fixed contract unemployed Job Title * Employer name * Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
First name * Surname * Date of Birth (dd/mm/yyyy) * Home Phone Mobile Phone * Email * Address * Borough * Postcode * What is your current residential status? * please select Renting Privately Living with Friends/Relatives Housing Association Tenant Local Authority Tenant Owner/occupier Other National Insurance number * How many children/other dependants do you have? * please select 0 1 2 3 4 or more What is your relationship to the other applicant? * please select Spouse Partner Son/daughter Sibling Friend none - single applicant Parent Carer Other Please confirm your nationality * please select British EU national Non EU national If EU national please specify country If Non EU national is evidence of indefinite leave to remain provided? please select Yes No Employment Please confirm your current employment status * please select employed self-employed temporary contract fixed contract unemployed Job Title * Employer name * Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Surname * Date of Birth (dd/mm/yyyy) * Home Phone Mobile Phone * Email * Address * Borough * Postcode * What is your current residential status? * please select Renting Privately Living with Friends/Relatives Housing Association Tenant Local Authority Tenant Owner/occupier Other National Insurance number * How many children/other dependants do you have? * please select 0 1 2 3 4 or more What is your relationship to the other applicant? * please select Spouse Partner Son/daughter Sibling Friend none - single applicant Parent Carer Other Please confirm your nationality * please select British EU national Non EU national If EU national please specify country If Non EU national is evidence of indefinite leave to remain provided? please select Yes No Employment Please confirm your current employment status * please select employed self-employed temporary contract fixed contract unemployed Job Title * Employer name * Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Date of Birth (dd/mm/yyyy) * Home Phone Mobile Phone * Email * Address * Borough * Postcode * What is your current residential status? * please select Renting Privately Living with Friends/Relatives Housing Association Tenant Local Authority Tenant Owner/occupier Other National Insurance number * How many children/other dependants do you have? * please select 0 1 2 3 4 or more What is your relationship to the other applicant? * please select Spouse Partner Son/daughter Sibling Friend none - single applicant Parent Carer Other Please confirm your nationality * please select British EU national Non EU national If EU national please specify country If Non EU national is evidence of indefinite leave to remain provided? please select Yes No Employment Please confirm your current employment status * please select employed self-employed temporary contract fixed contract unemployed Job Title * Employer name * Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Home Phone Mobile Phone * Email * Address * Borough * Postcode * What is your current residential status? * please select Renting Privately Living with Friends/Relatives Housing Association Tenant Local Authority Tenant Owner/occupier Other National Insurance number * How many children/other dependants do you have? * please select 0 1 2 3 4 or more What is your relationship to the other applicant? * please select Spouse Partner Son/daughter Sibling Friend none - single applicant Parent Carer Other Please confirm your nationality * please select British EU national Non EU national If EU national please specify country If Non EU national is evidence of indefinite leave to remain provided? please select Yes No Employment Please confirm your current employment status * please select employed self-employed temporary contract fixed contract unemployed Job Title * Employer name * Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Mobile Phone * Email * Address * Borough * Postcode * What is your current residential status? * please select Renting Privately Living with Friends/Relatives Housing Association Tenant Local Authority Tenant Owner/occupier Other National Insurance number * How many children/other dependants do you have? * please select 0 1 2 3 4 or more What is your relationship to the other applicant? * please select Spouse Partner Son/daughter Sibling Friend none - single applicant Parent Carer Other Please confirm your nationality * please select British EU national Non EU national If EU national please specify country If Non EU national is evidence of indefinite leave to remain provided? please select Yes No Employment Please confirm your current employment status * please select employed self-employed temporary contract fixed contract unemployed Job Title * Employer name * Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Email * Address * Borough * Postcode * What is your current residential status? * please select Renting Privately Living with Friends/Relatives Housing Association Tenant Local Authority Tenant Owner/occupier Other National Insurance number * How many children/other dependants do you have? * please select 0 1 2 3 4 or more What is your relationship to the other applicant? * please select Spouse Partner Son/daughter Sibling Friend none - single applicant Parent Carer Other Please confirm your nationality * please select British EU national Non EU national If EU national please specify country If Non EU national is evidence of indefinite leave to remain provided? please select Yes No Employment Please confirm your current employment status * please select employed self-employed temporary contract fixed contract unemployed Job Title * Employer name * Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Address * Borough * Postcode * What is your current residential status? * please select Renting Privately Living with Friends/Relatives Housing Association Tenant Local Authority Tenant Owner/occupier Other National Insurance number * How many children/other dependants do you have? * please select 0 1 2 3 4 or more What is your relationship to the other applicant? * please select Spouse Partner Son/daughter Sibling Friend none - single applicant Parent Carer Other Please confirm your nationality * please select British EU national Non EU national If EU national please specify country If Non EU national is evidence of indefinite leave to remain provided? please select Yes No Employment Please confirm your current employment status * please select employed self-employed temporary contract fixed contract unemployed Job Title * Employer name * Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Borough * Postcode * What is your current residential status? * please select Renting Privately Living with Friends/Relatives Housing Association Tenant Local Authority Tenant Owner/occupier Other National Insurance number * How many children/other dependants do you have? * please select 0 1 2 3 4 or more What is your relationship to the other applicant? * please select Spouse Partner Son/daughter Sibling Friend none - single applicant Parent Carer Other Please confirm your nationality * please select British EU national Non EU national If EU national please specify country If Non EU national is evidence of indefinite leave to remain provided? please select Yes No Employment Please confirm your current employment status * please select employed self-employed temporary contract fixed contract unemployed Job Title * Employer name * Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Postcode * What is your current residential status? * please select Renting Privately Living with Friends/Relatives Housing Association Tenant Local Authority Tenant Owner/occupier Other National Insurance number * How many children/other dependants do you have? * please select 0 1 2 3 4 or more What is your relationship to the other applicant? * please select Spouse Partner Son/daughter Sibling Friend none - single applicant Parent Carer Other Please confirm your nationality * please select British EU national Non EU national If EU national please specify country If Non EU national is evidence of indefinite leave to remain provided? please select Yes No Employment Please confirm your current employment status * please select employed self-employed temporary contract fixed contract unemployed Job Title * Employer name * Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
What is your current residential status? * please select Renting Privately Living with Friends/Relatives Housing Association Tenant Local Authority Tenant Owner/occupier Other National Insurance number * How many children/other dependants do you have? * please select 0 1 2 3 4 or more What is your relationship to the other applicant? * please select Spouse Partner Son/daughter Sibling Friend none - single applicant Parent Carer Other Please confirm your nationality * please select British EU national Non EU national If EU national please specify country If Non EU national is evidence of indefinite leave to remain provided? please select Yes No Employment Please confirm your current employment status * please select employed self-employed temporary contract fixed contract unemployed Job Title * Employer name * Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
National Insurance number * How many children/other dependants do you have? * please select 0 1 2 3 4 or more What is your relationship to the other applicant? * please select Spouse Partner Son/daughter Sibling Friend none - single applicant Parent Carer Other Please confirm your nationality * please select British EU national Non EU national If EU national please specify country If Non EU national is evidence of indefinite leave to remain provided? please select Yes No Employment Please confirm your current employment status * please select employed self-employed temporary contract fixed contract unemployed Job Title * Employer name * Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
How many children/other dependants do you have? * please select 0 1 2 3 4 or more What is your relationship to the other applicant? * please select Spouse Partner Son/daughter Sibling Friend none - single applicant Parent Carer Other Please confirm your nationality * please select British EU national Non EU national If EU national please specify country If Non EU national is evidence of indefinite leave to remain provided? please select Yes No Employment Please confirm your current employment status * please select employed self-employed temporary contract fixed contract unemployed Job Title * Employer name * Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
What is your relationship to the other applicant? * please select Spouse Partner Son/daughter Sibling Friend none - single applicant Parent Carer Other Please confirm your nationality * please select British EU national Non EU national If EU national please specify country If Non EU national is evidence of indefinite leave to remain provided? please select Yes No Employment Please confirm your current employment status * please select employed self-employed temporary contract fixed contract unemployed Job Title * Employer name * Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Please confirm your nationality * please select British EU national Non EU national If EU national please specify country If Non EU national is evidence of indefinite leave to remain provided? please select Yes No Employment Please confirm your current employment status * please select employed self-employed temporary contract fixed contract unemployed Job Title * Employer name * Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
If EU national please specify country If Non EU national is evidence of indefinite leave to remain provided? please select Yes No Employment Please confirm your current employment status * please select employed self-employed temporary contract fixed contract unemployed Job Title * Employer name * Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
If Non EU national is evidence of indefinite leave to remain provided? please select Yes No Employment Please confirm your current employment status * please select employed self-employed temporary contract fixed contract unemployed Job Title * Employer name * Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Employment Please confirm your current employment status * please select employed self-employed temporary contract fixed contract unemployed Job Title * Employer name * Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Please confirm your current employment status * please select employed self-employed temporary contract fixed contract unemployed Job Title * Employer name * Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Job Title * Employer name * Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Employer name * Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Employer Address * Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Main employment Borough * Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Main employment Postcode * Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Financial Details What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
What is your GROSS annual income excluding benefits, bonuses, overtime and commission? * What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
What is your average annual gross income from bonuses/overtime/commission, but excluding benefits What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
What is your total savings amount? * How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
How much of your savings are available for your purchase? * Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Are you in receipt of state benefits? * please select Yes No If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
If yes, please confirm the total amount Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Do you have any count court judgements or lease/borrowing defaults registered against you or your current/recent addresses? * please select Yes No If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
If yes, please give details Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Have you ever been made bankrupt? * please select Yes No Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Have you been in rent or mortgage arrears in the last 12 months? * please select Yes No If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
If yes, please give details Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Is there any other relevant information relating to your application? 0 of Maximum 400 Characters Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Diversity questions Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Ethnic Origin * please select White - English/Welsh/Scottish/Northern Irish/British White - Irish White - Gypsy or Irish Traveller White - Any other White background (please specify) Mixed - White and Black Caribbean Mixed - White and Black African Mixed - White and Asian Mixed - any other mixed/multiple ethnic background (please specify) Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Asian/Asian British - Chinese Asian/Asian British - Vietnamese Asian/Asian British - Any other Asian background (please specify) Black - African Black - Caribbean Black - Any other Black/African/Caribbean background (please specify) Arab Any other ethnic group (please specify) Prefer not to say If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
If you selected "other - please specify" for the question above, please use this space to specify Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Do you have any health problems or disabilities that you expect will last for more than a year? * please select Yes No Prefer not to say (To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
(To select more than one hold Ctrl button and click those that apply) * If yes, please check all that apply Vision (for example, blindness or partial sight) Hearing (for example deafness or partial hearing) Mobility (for example walking short distances or climbing stairs) Dexterity (for example lifting and carrying objects, using a keyboard) Learning or understanding or concentrating Memory Mental health Stamina or breathing or fatigue Socially or behaviourally (for example autism, attention deficit disorder or Asperger's syndrome) Other - please specify
If you selected "other - please specify" for the question above, please use this space to specify Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
Gender * please select Male Female Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
If you selected "other - please specify" for the question above, please use this space to specify *
Please confirm your sexual preference * please select Heterosexual/Straight Gay/Lesbian Bisexual Prefer not to say Other - please specify If you selected "other - please specify" for the question above, please use this space to specify * What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
What is your religion? * please select Buddhist Christian Hindu Jewish Muslim Sikh Other no religion Prefer not to say What language should we contact you in? *
What language should we contact you in? *
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