Arataki Housing Referral Form - Arataki Ministries

Date(Required)

Phone Number(Required)

Email(Required)

Date of Birth(Required)

Ethnicity(Required)

Gender(Required)

Occupation

APPLICANT MUST MEET THE FOLLOWING CRITERIA

1. Applicant must have a current medical mental health diagnosis.(Required)

2. Applicant must be supported by a secondary service – Who?(Required)

(A professional service that will continued to support the applicant for 3 months into a successful tenancy).

3. Applicant must be registered with Social Housing (MSD).(Required)

DO YOU HAVE ANY DEPENDANTS?

(Children or Ward under 18yrs in your care)

EMERGENCY CONTACT

(Family/ Friends/ other)

HOUSING INFORMATION

Have you rented before?(Required)

How long have you lived at your current address?(Required)

Reason for moving from your current situation?(Required)

If you application is successful, how soon can you move?(Required)

Is there anything to disclose that may affect your housing application?(Required)

HOUSING NEEDS

What is your affordability?(Required)

(MSD provide a breakdown)

How many and what type?(Required)

TENANCY REFERENCE

From a previous Landlord or character references from a person of good standing that has known you for 12 months or more.

Community Housing relevant files(Required)

Please upload photo ID, benefit breakdown, any references and a cost cover letter for this referral to be accepted - NB: a cost cover letter is not negotiable and must be included for this referral to be accepted.

Drop files here or

Accepted file types: pdf, jpg, png, Max. file size: 2 MB, Max. files: 5.