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Housing Request Form
"
*
" indicates required fields
First name
*
Surname
*
Age
*
Please enter a number from
17
to
35
.
We only offer housing for people aged 18 to 35. If you are 17 and applying for please be aware that this will only be possible after your 18th birthday.
Date of Birth
*
Day
Day
1
2
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4
5
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11
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13
14
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16
17
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25
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29
30
31
Month
Month
1
2
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4
5
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10
11
12
Year
Year
2027
2026
2025
2024
2023
2022
2021
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2019
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1920
Email
*
Phone
Is this a single or joint application?
*
Single - one person
Joint - two people
Full name of joint applicant
*
Please tick to confirm that you will encourage the joint applicant to complete a housing request form for themself
*
If you apply together with a joint applicant, both of you will need to fill out a housing request form individually.
Confirm
Please tick to confirm you do not have parental responsibility for children that live with you. If you do, you are not eligible to apply.
*
If you have a parental responsibility for children but they do not live with you, you can tick this. If you are not eligible, please see
this website for other options available
.
Confirm
Please tick to confirm you do not have pets that live with you. If you do, you are not eligible to apply.
*
If you are not eligible, please see
this website for other options available
.
Confirm
Have you lived or worked in Milton Keynes for the last 12 months
*
Yes
No
If you have not, you will not be eligible to apply.
If yes, please tell us more:
Why are you applying for housing with YMCA? (tick all that apply)
Homeless / at risk of homelessness
Unstable or unsafe accommodation
Looking for support to live independently
Other
If "Other" please specify
Do you have any support needs we should know about? (e.g. mental health, employment, training, wellbeing)
Professionals involved and contact details
Where are you currently living? (tick all that apply)
Sofa surfing (staying with friends/family short-term)
Homeless (no fixed place to stay)
Hostel / supported housing
Private rented accommodation
Living with parents / guardians
If "Other" please specify
Briefly describe your current housing situation.
Source of income/Employment status
*
Please note that your employment status does not have an impact on your application. It is used solely to determine which level of our service is best suited to you.
Universal Credit
Personal Independence Payment (PIP)
Any other benefit
Full time work
Part time work
Dancebox
No income
Are you currently receiving, or able to apply for, Housing Benefit / Universal Credit?
*
Yes
No
Not sure
Additional Information
Please use this field if you wish to briefly provide any additional information.
We are unable to accept applications from DanceBox students. We apologize for the inconvenience.
Data Consent (GDPR)
*
At YMCA Milton Keynes we collect and store information about you on our secure database. We do this for two main reasons, firstly in our role as landlord we have a legal obligation to hold information related to your licence agreement and contract of stay with us. Secondly, we hold information for legitimate interest reasons that allows us to undertake our work as a supported housing provider such as information about your wellbeing, education and employment etc. I fully understand that YMCA Milton Keynes may contact the Police and other professional bodies. I authorise YMCA Milton Keynes to assess my needs and suitability for the service. I declare that the information I’ve given to YMCA Milton Keynes, and any documents I have submitted, is true and that I have answered the questions fully and accurately.
Agree
I understand my data will be stored and shared as above.
*
Agree
I agree to my photograph being taken when I move in, and stored on the database.
Agree
I agree that you can share my information with MK Council and any other relevant services.
Agree
I agree to YMCA Milton Keynes contacting me once I have left.
Agree