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Relationship Breakdown (Bha Tenant) Information/Application Form

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Relationship Breakdown (Bha Tenant) Information/Application Form STATUTORILY HOMELESSNESS/ RELATIONSHIP BREAKDOWN (BHA TENANT) INFORMATION/APPLICATION FORM If you wish to make a homeless application you should apply immediately to your Local Authority (in the Scottish Borders area this is Scottish Borders Council). You can access the homeless service through any Scottish Borders Council Contact Centre or by contacting the homeless service direct at the address below. Your Local Authority will discuss housing options with you. If Scottish Borders Council accepts a duty to house you as a homeless person and refers you to Berwickshire Housing Association, then you will receive Gold Priority for housing. If Scottish Borders Council does not accept a duty to house you but nevertheless deems you are in significant housing need and/or at risk of becoming homeless, you may qualify for bronze priority if a referral is made and confirmation of your housing options agreement is received. Finally, if you wish to make a homeless application to the Scottish Borders Council from another Local Authority area your Local Authority can, in certain circumstances, make a ’homeless referral’ to Scottish Borders Council. For more information contact your own Local Authority. Scottish Borders Council, Homelessness Services, Paton Street, Galashiels TD1 1AS Tel: 01896 661 385 Out of Hours Service Bordercare: 01896 752111 Freephone Number 0800 376 1138 Additionally, BHA will award a Gold pass to existing BHA tenants demonstrating relationship breakdown. In order to assess your Relationship Breakdown (BHA Tenant) Priority application, please complete form in full. APPLICATION: Homehunt Registration Number ___________________ Your Name ________________________________________________________________________ Your Address ______________________________________________________________________ Telephone: Home ________________ Work ________________ Mobile _____________________ Relationship Breakdown (BHA Tenant) Are you a current BHA tenant and have had a Yes No relationship breakdown? if Yes, please give us details of your relationship breakdown ________________________ ________________________________________________________________________ ________________________________________________________________________ Please sign here ________________________________ Date __________________________ I confirm that the information I have given is correct and that I have not supplied any false or misleading information, or withheld any relevant information. I agree to the use of this information in accordance with the data protection notice as stated in the ‘Berwickshire Housing Association Guide’ booklet. Note: You can list specific locations or tell us a wider area which you would consider. We may contact you to discuss suitable locations when assessing your priority. PLEASE TICK WHICH AREAS YOU WOULD LIKE YOUR PRIORITY TO COVER You must apply for ALL suitable properties in the areas chosen or your priority will be removed after six months (please see the BHA Guide Booklet for more information about your priority) Coldstream Area Duns Area Eyemouth Area Eyemouth Area (contd) Birgham Allanton Ayton Grantshouse Coldstream Chirnside Cockburnspath Hutton Eccles Cranshaws Coldingham Lower Burnmouth Gordon Duns Eyemouth Deanhead Paxton Greenlaw Gavinton Eyemouth Gunsgreen Reston Hume Longformacus Eyemouth Old Town St. Abbs Leitholm Preston Foulden Upper Burnmouth Swinton Westruther Whitsome Sheltered Housing Developments If you have indicated a sheltered Housing Requirement on your registration form, please tick to choose the Developments you wish your pass to apply to: Coldstream, Gowanlea Court Duns, Boston Court Eyemouth, Linkim Court .
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