Basingstoke application form

Your details

Your full name (Required):

Date of birth (Required): 
What best describes your gender? (Required):
Nationality (Required): 
How did you find out about Optivo Keyworkers? (Required): 
 

Your contact details

Email (Required): 

Phone number (Required): 
 
Current Address (Required): 
 

Identification

All applications for accommodation (over 28 days) will need a Right To Rent compliance check, as required by the Immigration Act 2014. Optivo works with NSL Checking to complete these checks. Once we have reviewed your application we will use your email address and/or mobile number to register your enquiry with NSL Checking, who will contact you directly. For more information go to: http://optivo.nsl.co.uk

National Insurance number: 

Passport number (Required): 
 

Accommodation Requirements

What type of accommodation would you like to rent from Optivo? (Required): 

Date I would like to move into my accommodation (Required): 

Do you require car parking? (Required): 

Note: car parking availability can be limited and some schemes operate a waiting list or have none. Let us know your requirements and we will advise you if we can assist.

Please advise us how you intend to pay for your rent (Required):
​To ensure Optivo meets our Housing Association charitable aims we will need to know about how you will be able to pay the rent for your new accommodation.

 

Safety

In the event of an emergency evacuation, we're required to know if you have any mobility issues, sensory issues or cognitive impairments that may prevent you from self-evacuating. Please tick any that apply: (Required)

 

Keyworker status eligibility

I am a... (Required):

If you're a keyworker not working for the NHS, please tell us who you work for below:

Employer's name: 

Job Title: 
Department: 
Contract Type: 
 
 

Confirmation Statement

I confirm that the information given on this form is correct to the best of my knowledge, and that no relevant information has been withheld.

If I am found to have withheld information now or in the future relating to my application for accommodation, Optivo reserves the right to withdraw any offer made or may request that you vacate the accommodation.

I understand that the information provided will be treated in the strictest confidence and according to Optivo’s Privacy Notice (click here to read).