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Edward Mayes Trust has an estate of 48 properties at Mayes Garden in Ancoats, Manchester, and manages 21 properties in Bolton, Sale and Denton.

You can apply online today or get in touch to find out more.

Data Protection Statement: it is part of the Trusts responsibilities to ensure that applicants for its property are suitably qualified under the terms of the charity's governing document. The Trust therefore needs to investigate the personal circumstances of applications. The personal data supplied on this form and other information relating to the almshouse appointment and your housing support will be held on file. Some details may be checked with relevant organisations since the charity reserves the right to investigate and verify what you write on this form, but no details will be disclosed for any inappropriate purpose. You may have access to your personal information on request.

Please complete the form and be frank and open with us. We are asking the questions set out below so we can make sure we have the right information to help us decide whether our property will suit you and where we can give you the help and support you need. If you want any help filling out the application form or have any question please contact us on 0161 273 6611

ABOUT YOU

Is this a joint application?

Yes No

Do you have permission to reside permanently in the UK?

Yes No

Do you own and drive a car?

Yes No

Are you a blue badge permit holder?

Yes No

Do you have any pets?

Yes No

YOUR LOCATION

Please give details of your addresses in the last five years

Our accommodation is provided for the benefit of people who have a local connection to Manchester. In some circumstances we may also consider connections to Greater Manchester areas.

When did you move into your current address?

What type of property are you living at now? House Flat Maisonette Bungalow Bedsit

If renting please provide the name and address of your current landlord

YOUR NEEDS & PREFERENCES

Are you in need of sheltered housing?

Yes No

Are you experiencing harassment or threats of violence?

Yes No

Please tell us about any long standing or permanent health problems or disability you or the joint applicant have

Do you receive support or assistance in any of the following ways?

Home Care

Yes No

Regular visits from GP

Yes No

Visits from a nurse

Yes No

Day care at a day centre

Yes No

Meals Delivered

Yes No

Visits from a volunteer

Yes No

Regular help with domestic tasks from relatives or friends

Yes No

Regular help with personal tasks from relatives or friends

Yes No

Do you receive any support from any other agency? e.g. social worker, probation officers, mental health team etc. If so, please tell us who they are and where they can be contacted.

Please tell us about their contact with you such as what they help you with and how often you see them

EQUAL OPPORTUNITIES

Do you consider yourself to have a disability?

Yes No

Are you

Male? Female?

How do you regard your sexuality?

Heterosexual Gay/Lesbian Bi-sexual Question Refused

FINANCIAL ASSESSMENT

Weekly income i.e. Pensions, welfare benefits, salary

How is this made up?

Do you currently receive Housing Benefit at your current address?

Yes No

If so, how much Housing Benefit do you receive per week?

Amount of savings/investments

Do you own any property either residential or commercial?

Yes No

If so, what is the current market value of your property?

ALMOST THERE!

Is there anything else that you think we should know about which is relevant to your application?

Please provide the name and address of your GP

Declaration

I confirm that the information given above is correct and complete to the best of my knowledge and belief and agree to inform Edward Mayes Trust of any changes in the details given in this form.

I understand that if in answering the above, I knowingly or recklessly give false information or withhold information the Trust are entitled to terminate any appointment to an almshouse dwelling I may be given as a result of this application.

I accept that if I am appointed as a resident I shall be a beneficiary of the charity and not a tenant. Any weekly sum I pay will be a maintenance contribution and not rent.

I confirm I am able to look after myself and to live independently, with the assistance of family and carers if necessary.

I consent to my GP or other medical attendant providing the charity with a medical certificate or report abut my health and condition now or at a future date in accordance with the terms of the attached form of authority.

I consent to the charity holding personal data on this form in accordance with General Data Protection Regulations.

I agree that the charity may contact me by (please tick as appropriate)

E-Mail Post Telephone

I understand that the information on this form will be used to process the application. By signing this form I give my consent for you to verify this information with relevant agencies.

ABOUT YOU

YOUR LOCATION

YOUR NEEDS & PREFERENCES

EQUAL OPPORTUNITIES

FINANCIAL ASSESSMENT

ALMOST THERE!