Zebra Housing Association
About
About Zebra
Vision and values
What we offer
Family friendly accommodation
Equality and diversity
Value for money
Social programme
Properties
Impala House NW1
Jerome House SW7
Sentosa House N1
Jeannine House W1
Anson Road & Carleton Road N7
How to apply
Info For Residents
Fire Action Plan
Reporting a Repair
Living in your home
Healthcare, Benefits & Safety
Your legal rights
Your Warden
Feedback & Complaints
Customer care charter
Friends of Zebra
Contact
FAQS
Facebook-square
Twitter-square
Online Application Form
Please complete all sections. Failure to do so may result in your application being rejected.
Personal Details
Last Name
Other Name
Title
Gender
Male
Female
Date of birth
Date Format: DD slash MM slash YYYY
Nationality
Present Address
Postcode
Email
Home Phone
Mobile Phone
Home Country Address
Who will be living with you in ZHA accommodation
(Please note we do not house siblings, parents or friends. Dependants and spouses only)
First Person
Name
Relationship
Date of Birth
Second Person
Name
Relationship
Date of Birth
Third Person
Name
Relationship
Date of Birth
Location Preferred
Please select your preferred location but be aware that we operate a ‘one offer only policy’ and therefore if you refuse an offer you will be removed from the waiting list. Please also be aware that you will not be considered for accommodation which is larger than your needs require.
Location
Jerome House SW7
Jeannine House W1
Sentosa House N1
Impala House NW1
Anson N7
How did you hear of ZHA
University / College
Which university/college are you attending
Title of course/degree
When does this course start
When does this course end
ACCOMMODATION REQUIRED
(All ZHA properties are let for a minimum of six months)
When do you require accommodation
How long do you require accommodation
Size of accommodation preferred
Single room
Double room
Studio
1 bed flat
2 bed flat
Notice required at present address
Do you have a disability or particular requirement
Income
Monthly Income
Where does this come from
Your monthly budget for rent
Equality and Diversity Monitoring
Zebra Housing Association strives to operate a policy of equality and diversity and not discriminate against any person. For this reason we monitor all aspects of our business including who serves on our Board. The information you provide will be treated in the strictest confidence. The information is reported to our regulator and forms part of an annual report to the Board – see the Equality and Diversity policy approved by the Board in November 2009 and amended in September 2012.
Ethnic Origin
White: British
White: Irish
White: Any Other
Black or Black British: Caribbean
Black or Black British: African
Black or Black British: Any Other
Mixed: White and Black Caribbean
Mixed: White and Black African
Mixed: White and Asian
Mixed: Any Other
Asian or Asian British: Indian
Asian or Asian British: Pakistani
Asian or Asian British: Bangladeshi
Asian or Asian British: Any Other
Other: Chinese
Other: Any Other Ethnic Group
I do not wish to disclose my ethnicity
Age Group
20-29
30-39
40-49
50-59
60-69
70-79
Over 79
Religious Belief
Atheism
Buddhism
Christianity
Hinduism
Islam
Jainism
Judaism
Sikhism
I do not wish to disclose my belief
A person has a disability under the Disability Discrimination Act if he/she has a physical or mental impairment which has a substantial and long term adverse effect on his/her ability to carry out normal day to day activities. Long term means has lasted, or is expected to last, for 12 months. Do you consider yourself to be a disabled person.
Disability
Yes
No
I do not wish to disclose
Married/Civil Partnership
Yes
No
I do not wish to disclose
Are you Pregnant
Yes
No
I do not wish to disclose
I confirm that all the information supplied is correct and understand that if it is later found to have been false, I risk losing any accommodation I am offered. I understand that should I cease to be a full time student my application will no longer be valid.
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