Coventry

Friday, 30-Jul-2010

Online application form

About you

Data Protection

Data Protection Act 1998

The Data Controller is Coventry City Council

The details you provide on this form will be used in connection with your Homefinder application and for research, analysis and statistical purposes regarding the needs and further development of housing in Coventry.

In order to process your application and subsequent use of the Homefinder system your information will be shared with the partner Housing Associations in their role of deciding who to offer a tenancy to.

The partner Housing Associations include, but are not limited to:
Ashram Housing Association
Sanctuary Housing Association
Guinness Northern Counties Housing Association
Housing 21
Jephson Housing Association
Mercian Housing Association
Midland Heart Housing Assocation
Nehemiah Housing Association
Orbit Heart of England Housing Assocation
Starley Housing Co-operative
Whitefriars Housing Group

Abritas Limited has a contract with Coventry City Council to host the Web-based system that holds the information that you provide.

We may wish to contact you in future when undertaking customer satisfaction and Homefinder usage surveys. These will be undertaken by Coventry City Council or its nominated agents.

Occasionally we may need to share information with other organisations. This information will be shared only on a strictly need to know basis and will be done for example to prevent and detect crime and fraud or for other lawful reasons.

What this means is that information held about you may be passed to other local authorities, law enforcement agencies, Health organisations and other appropriate organisations if there is a valid and lawful reason. If another person or organisation requests information that we hold about you, it will not be released unless they are entitled to it by law.

It is assumed that by completing this online application form you agree to the terms regarding the processing and sharing of information.

If you have previously started an online application, then enter your reference number and date of birth below to log in.

Reference number:

Date of birth: (dd/mm/yyyy)

Otherwise, please start entering your information below. Note that questions marked with * are mandatory for you to answer.

About you

Title:*

Surname:*

First name:*

Previous surname/names if any:

Address line 1:*

Address line 2:*

Address line 3:

Address line 4:

Postcode:*

Date moved in to this address:* (dd/mm/yyyy)

Home telephone:

Work telephone:

Mobile telephone:

E-mail address:

National insurance number:

Date of birth:* (dd/mm/yyyy)

Gender:*

Ethnic origin:*

Nationality:*

Note: EEA refers to the European Economic Area and it includes all European Union countries as well as Iceland, Norway, Liechtenstein.

If other nationality please specify

Immigration status*

Sexuality

Religion

Pregnant? yes no

If yes, then when is the baby due: (dd/mm/yyyy)

Child access: yes no

Child access details:

Correspondence address

Same address as main applicant: yes no

If yes, then please ignore the following address fields

Address line 1:*

Address line 2:*

Address line 3:

Address line 4:

Postcode:*