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Reserving a Flagship home - shared ownership

Please let us know if you need any help filling in this form.

Reserving a Flagship Home

"*" indicates required fields

Do you and or your partner (where applicable) have any difficulties reading or writing?

Yes

No

Do you require communication in an alternative format?

Do you require communication in an alternative format?

Please give details

Property reserved

Address

Address Postcode

Date of reservation

Day

Month

Year

Purchaser 1

Title*

Mr

Mrs

Miss

Ms

other

Name*

First name(s) Surname

Date of birth*

Day

Month

Year

Age*

Please enter a number from 1 to 150.

Sex*

National insurance no.

Address*

Street Address Address Line 2 County Postcode

Telephone no.

Mobile no.

Email*

Nationality*

Would you like to add a second purchaser?*

Yes

No

Would you like to add any dependent children?*

Yes

No

Would you like to add any non-dependent household members?*

Yes

No

Purchaser 2

Title

Mr

Mrs

Miss

Ms

other

Name

First name(s) Surname

Date of birth

Day

Month

Year

Age

Please enter a number from 1 to 150.

Sex

National insurance no.

Address

Street Address Address Line 2 County Postcode

Telephone no.

Mobile no.

Email

Nationality

Would you like to add any dependent children?*

Yes

No

Would you like to add any non-dependent household members?*

Yes

No

Dependent children

How many dependent children would you like to add?

1

2

3

4

5

6

Dependent child 1

Name

First name(s) Surname

Date of birth

Day

Month

Year

Sex

Relationship to applicant

Dependent child 2

Name

First name(s) Surname

Date of birth

Day

Month

Year

Sex

Relationship to applicant

Dependent child 3

Name

First name(s) Surname

Date of birth

Day

Month

Year

Sex

Relationship to applicant

Dependent child 4

Name

First name(s) Surname

Date of birth

Day

Month

Year

Sex

Relationship to applicant

Dependent child 5

Name

First name(s) Surname

Date of birth

Day

Month

Year

Sex

Relationship to applicant

Dependent child 6

Name

First name(s) Surname

Date of birth

Day

Month

Year

Sex

Relationship to applicant

Non-dependent household members

How many non-dependent household members would you like to add?

1

2

3

4

Non-dependent household member 1

Name

First name(s) Surname

Date of birth

Day

Month

Year

Sex

Relationship to applicant

Full time employment

Yes

No

Non-dependent household member 2

Name

First name(s) Surname

Date of birth

Day

Month

Year

Sex

Relationship to applicant

Full time employment

Yes

No

Non-dependent household member 3

Name

First name(s) Surname

Date of birth

Day

Month

Year

Sex

Relationship to applicant

Full time employment

Yes

No

Non-dependent household member 4

Name

First name(s) Surname

Date of birth

Day

Month

Year

Sex

Relationship to applicant

Full time employment

Yes

No

Next of kin/emergency contact details

We will use this if we cannot contact you/have concerns about you. By providing these details you’re giving us consent to use them in an emergency or when we have concerns for your wellbeing or safety.

Next of kin (lead customer)

Name

First name(s) Surname

Contact number

Email

GP surgery

Next of kin (second customer)

Name

First name(s) Surname

Contact number

Email

Relationship to applicant

GP surgery

About you

Please answer for both yourself and the second customer (where applicable). If yes to any of these questions please provide details

Does anyone advocate for you?*

Yes

No

Does anyone in the household have a long term illness, disability or learning disability?*

Yes

No

Does anyone in the household need support with neurodiversity?*

Yes

No

Are you and/or your partner subject to immigration control?*

Yes

No

Please provide details

Alongside the general information you provide as part of your application, we also ask you for some ‘enhanced data’. This extra level of detail helps us learn more about you and any reasonable adjustments you might need in order to access all our services.

Lead customer - Enhanced data

Gender identity*

If 'Other' please state*

Sexual orientation*

If 'Other' please state*

Religion / Belief*

If 'Other' please state*

Race / Ethnicity*

If 'Other' please state*

Nationality*

If 'Other' please state*

Second customer - Enhanced data

Gender identity*

If 'Other' please state*

Sexual orientation*

If 'Other' please state*

Religion / Belief*

If 'Other' please state*

Race / Ethnicity*

If 'Other' please state*

Nationality*

If 'Other' please state*

Any additional information you would like to us to know about:

Description

I declare that the information provided to Flagship Homes is truthful and accurate.

I give consent to Flagship Homes to store the information within this application form on their system.

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Comments

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PLEASE NOTE: All CGI's and digital design images are for illustration purposes only and may be subject to change. Please ask a sales representative for more information.

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Email us: info@flagship-homes.co.uk

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