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* Denotes Mandatory Field
For security, please provide a password for your account *
(this must be at least 8 characters)
Please enter password again *
(this must be at least 8 characters)
For security - please enter your mother's maiden name *
If you are already a tenant of Homes Plus tick the box:
Title * Gender *
First Name(s) * Surname *
Date of Birth * National Insurance Number *
To be entered as a whole number, no spaces
Ethnic Origin * Marital Status *
Special Needs *
If you choose one of the following options, a medical form will be sent to you
Preferred Language (Spoken) *
Have you rented a property either from a private landlord, council or housing association in the past 6 years? * Yes No
Do you have access to the internet? * Yes No
Which of the following locations would you find most convenient to access information about our properties which are currently available?
Internet Supermarket Leisure Centre
Library Post Office Doctors Surgery
Council Office Homes Plus Office Other
Postcode *
Please make sure you include a SPACE in the postcode e.g. (ST18 9AP)
Property Name *
E.G "The Farmhouse", if your property has a number, not a name, please leave this blank and complete the Property Number below
Property Number *
Street *
Town *
County *
Contact address
Same As Above Address
Other Details
* You must give at least one of the following items of information:
Home Telephone
Work Telephone
Mobile Telephone
If you provide an email address we will use this as a primary method of contact when processing your application. We may contact you to request further information or evidence to support your circumstances. You will also receive a weekly copy of our advertisements via email.
If you would prefer not to be contacted by email please tick the box