Key workers equity loan application

Contact Information

First Applicant

Joint Applicant

Title

First Name

Surname

Date of birth

Address
If you have lived elsewhere in
the last 3 years, please list all your
previous addresses as well

Postcode

Which local authority area do you live in?

Which local authority area do you work in?

Home telephone number

Mobile telephone number

Daytime telephone number

Email address

Do these statements apply to you

First applicant

Joint applicant

I have access to at least £1,500 to cover the cost of buying

I have never failed to keep up payments on any loan or form of credit agreement

I have never had a County Court Judgement registered against me

I have not been behind with my rent in the past 12 months

Please include a rent reference if applicable

Occupation

First Applicant

Joint Applicant

Occupation

Job Title

Employer's name and address

Your base location if different from employers address

Employer's telephone number

Are you permanently employed?

How long have you worked in your profession?
(if less than 12 months please list employment
history on a seperate sheet)

If you work for the NHS which trust?

Probation

If you work within Probation which grade?

Teacher

Do you have a Qualified Teacher status?

Name of school/college

Main subject taught

Classification of school

Is your school government funded?

Income/Savings

First Applicant

Joint Applicant

Total annual income before deductions (excluding overtime & bonues)

Monthly take home pay

Total savings (inc. equity from property sales)

Do you have any outstanding loans or other regular payments (including credit cards)

If yes how much is the current balance?

How much are your monthly repayments?

Citizenship

First Applicant

Joint Applicant

Are you a British or EU/EAA citizen?

If not, is your passport stamped with "Indefinite leave to remain"?

Who else will be living with you?
Please include full name and status. If they are aged between 16-21
please state whether they are in full time education or working.

Current Status

First Applicant

Joint Applicant

Are you:

If you are on a council waiting list please say
where and give your reference number

How many bedrooms does your current home have?

Is it a flat or house?

If it is a flat, on what floor?

Does it have a lift?

If you are a council or housing association tenant
or private tenant, please give the name and telephone
number of your landlord and the name and telephone number of your Housing Officer if applicable:

Which local authority area would you like to live in?

If applying for a particular scheme please state which one:

Teachers

If you are a school teacher please tick the boxes below which apply to you and ask your head teacher to sign and date this form.

Advanced Skills Teacher
AST are excellent classroom teachers who wish to remain in the classroom and share their excellent skills with other teachers.

Fast Track
The Fast Track Teaching Programme is for new entrants and existing teachers with high leadership potential. It focuses on rapid development of professional excellence and school leadership, and provides additional support and training.

Threshold
Teachers are normally paid on the Main Pay Scale that runs from M1 (lowest) - M6 (highest). Teachers can be at any point on the Scale depending on experience and qualifications. Teachers who have reached M6 can apply to cross the Threshold to the Upper Pay Scale and to demonstrate excellence in their work.

Shortage Subject
English (including drama), Maths, Modern Languages, Science, Design & Technology and ICT.

Managment Leadership

Challenging School Points

Health Workers

If you are a health worker, please select your employer organisation and tick your employee group in the lists below.

Employee Group

Nursing staff in general including children's nurses and midwives

Cancer services staff, particularly theraputic radiographers

Diagnostic support staff, particularly Diagnostic radiographers

Mental Health professionals e.g. mental health nurses and graduate workers in Primary Care

Allied Health Professionals

Pharmacists

GP's in under-doctored areas

Equal Opportunities

It is against the law and our equal opportunities policy to discriminate against anyone because of their sex, colour, race, religion, disability or sexual orientation. In order to ensure that we do not discriminate, we need to keep records. If you do not answer this question it will not affect your application in any way. Sensitive personal data such as ethnic origin, and physical or mental disabilities are required under the Equal Opportunities Monitoring statute. Under section 29(3) of the Data Protection Act 1998 the information may be disclosed for purposes of crime prevention and detection.

First Applicant

Joint Applicant

How would you describe your ethnic origin?

Do you consider yourself to be disabled?

If yes, please supply details

Are you related to a current or
former Committee/Board member or officer of a Registered Social Landlord (Housing Association)?

If yes, please tell us their name and which housing association

Orbit First Step will only process your personal data for the purpose of processing your application for housing and will hold your information in accordance with the Data Protection Act 1998.

All information you give us on this form (and information resulting from contact with you landlord and/or employer) may be shared with the same only in relation to this application.

All information will be treated in the strictest of confidence. We, other zone Agents and partner Registered Social Landlords (RSLs), reserve the right to take up and references relating to applicants as we consider it necessary and may also search the files of any credit reference agency which will keep a record of such request.

We must protect the public funds we handle and so may use the information you have provided on this form to prevent and detect fraud. Under section 29(3) of the Data Protection Act 1998 the information may be disclosed for purpose of crime prevention and detection. Sensitive personal data such as racial or ethnic origin, offences (including alleged offences) and physical or mental disabilities are required under the Equal Opportunities Monitoring Statute.

We may also share this information for the same purposes with other organisations that handle public funds. The information may be used for statistical surveys, which means we may pass this information in confidence to the Office of the Deputy Prime Minister and agencies working on our and their behalf.

Declaration: It is a criminal offence to knowingly or recklessly make a false declaration or withhold information reasonably required in connection with your application. I/We have read the above and confirm that I/we have provided accurate and up-to-date information relating to my/our application for home ownership. I/We understand that if it is found that false information has been given to obtain housing either knowingly or recklessly, appropriate legal action maybe taken and the RSL or local authority and/or seek possession of any leasehold tenancy granted. (Translation service available if required).

I understand that as a council, housing association or other public sector tenant, I will be required to give up my rented home on the day of completion if I buy or rent a home through any of the RSLs offering homes to key workers.

I authorise Orbit First Step to pass information to other Zone Agents, partner RSLs, credit reference agencies and to Estate Agents who may be able to assist in locating properties for applicants.

I authorise my employer to disclose to Orbit First Step any information relevant to this application.

Please check you have filled in all sections, otherwise you will need to re-apply.

 

Finally, where did you hear about this scheme?
If through a local paper, please state which one.