Application Form

Personal Information

First Name

Last Name

Address Line 1

Address Line 2

City

Local Authority Area Select Local Authority Area Aberdeen City Aberdeenshire Angus Argyll and Bute City of Edinburgh Clackmannanshire Dumfries and Galloway Dundee City East Ayrshire East Dunbartonshire East Lothian East Renfrewshire Falkirk Fife Glasgow City Highland Inverclyde Midlothian Moray Na h-Eileanan Siar North Ayrshire North Lanarkshire Orkney Islands Perth and Kinross Renfrewshire Scottish Borders Shetland Islands South Ayrshire South Lanarkshire Stirling West Dunbartonshire West Lothian

Postcode

Email Address

Mobile Number

Age Range Select Age Range 16-25 26-35 36-45 46-55 56-65 66-75 76-85 85+

Housing Information

What is the name of your Landlord?

What is the name of the group you are a member of?
If you are not a member of a group and are applying for one of the five individual positions, please type "Individual"

To be on our Committee, you must be a social housing tenant or service user.
Which of the following applies to you?

Council Tenant Council Service User (Resident)

Housing Association Tenant Housing Association Service User

Experience

Describe your experience with tenant participation or community involvement?

What skills or perspectives can you bring to the committee?

Availability

Are you available for meetings during working days? (Monday to Friday, 9am to 5pm)

Yes No Other

Other (please specify)

Devices

What devices do you have access to?

Computer iPad Tablet Smartphone Other

Other (please specify)

Additional Information

Is there any other information you wish to inform us about?

Reference

It is preferable that this be a member of staff from your landlord that knows you.

Name

Position

Phone Number

Email Address