You have expressed an interest in being considered for voluntary housing. This form is designed to provide us with information to assess the type of housing that will be best suited to your needs and to ensure you are provided support to maintain a tenancy should you require it.
Please ensure that you fill out all relevant sections of the form and that the information you provide us is true and accurate. Withheld or false information may impact on your application for housing with Circle Voluntary Housing Association.
Alternatively you can download, print and complete a PDF version of this form and post it back into us. Download Form.
We will request you to upload these later in the form process
A recent photo of drivers’ licence, passport, national age card issued by An Garda Síochána, public services card.
Any supporting documentation relating to a requirement for specially adapted accommodation.
We want to know about where you currently live and where you have lived to help us understand what type of accommodation best suits your needs.
Addresses might include a home you owned, a rented home, social housing or emergency accommodation.
Maximum number of addresses reached.
Maximum number of dependents reached.
We want to make sure that you enjoy living in your new home and that you receive any relevant support. To do that we would like to know if you are currently receiving support, or need support in any of the following areas?
Maximum number of support needs reached.
Maximum number of support workers reached.
Maximum number of legal issues/offences reached.
Please read the statements below carefully and check the relevant consent boxes.
To the best of my knowledge, all the information that I have given on this application form is accurate. I understand that if I have knowingly given inaccurate information my application may be refused.
Circle Voluntary Housing Association is collecting this information, so we can assess the type of housing that will be best suited to your needs.
To process your application, we will need to share the information you have supplied with your localauthority and other relevant services that you have identified on this form. This is to ensure you are safe in your home and to ensure we can support you to live in your home. We ask you to give consent to this.
Circle Voluntary Housing Association will follow the principles of the Data Protection Act and will make sure
that the information you have provided is:
Your confidentiality is assured except when there is an issue around child safety; violence to yourself or others; the courts request a report, or you inform the worker of a criminal act you have committed or intend to commit.
Please now use the 'previous' and 'next' buttons to check through your application to make sure that everything is correct and in place.
When you are ready, please click the submit button below.
Thank you for taking the time to submit the form.
Circle VHA, Phoenix House, 32-34 Castle Street, Dublin 2, Ireland.