Small Heath Park Housing Co-operative

Housing application

Apply for housing with Small Heath Park Housing Co-operative.

This online application follows the five-page 2025 housing application form. You can also download the paper form (PDF) and return it to 15 Rochdale Walk, Small Heath, Birmingham, B10 0DF.

There is high demand and properties rarely become available. Please read how homes are allocated before applying. For help completing the form, call 0121 773 3251.

Fields marked (required) must be completed. Complete other questions where they apply.

How this form uses your information

A · Personal details

Complete the form as clearly and fully as you can. Contact the office if you need help.

Include the postcode. If you have no fixed address, describe your current situation.

Optional at this stage. You can discuss this with the office.

Optional. The office can use this address to contact you.

Is this a joint application? (required)

Include the postcode. If you have no fixed address, describe your current situation.

Optional at this stage. You can discuss this with the office.

Leave blank if correspondence should go to your current address.

Optional. The choices follow the paper form. The co-operative aims to treat all applicants fairly regardless of nationality, sex, colour or religious belief.

A · Household and housing needs

A5. Other people who will live with you

List everyone moving with you, excluding the main and joint applicants. Leave unused rows blank.

Person 1
Person 2
Person 3
Person 4
Person 5
Person 6
Person 7
Person 8

Optional. Include only information relevant to your housing needs.

A8. Does anyone require special facilities? (required)

A9. People at your current address who will not move with you

Person 1
Person 2
Person 3
Person 4
Person 5
Person 6
Person 7
Person 8

A10. Previous addresses in the last five years

Include the address, length of stay and whether you were an owner, tenant, lodger or had another arrangement. Leave unused rows blank.

Previous address 1
Previous address 2
Previous address 3
Previous address 4
Previous address 5
Previous address 6
Previous address 7
Previous address 8

Two-bedroom bungalows are only allocated to elderly applicants or people with specialist needs.

B · Employment and present housing

You will be asked for evidence of household income and rent or mortgage payments. Arrange this with the office; do not send documents through the contact form.

B1. Would you be prepared to discuss your income at an interview? (required)

If you are a tenant.

Give the council name and date of registration for each waiting list, or state “None”.

For example, dampness, heating and state of repair.

B · Facilities in your present home

B · Membership and local connections

If so, give their name and address. Otherwise state “No”.

Include any positions or responsibilities you hold or have held.

B15. Skills you could contribute

Select all that apply.

B16. Connections to the local area

Select all that apply.

Declaration

  1. I/we understand that completing and signing this form does not mean that I/we will be offered housing.
  2. I/we agree to be interviewed by a sub-committee of the co-operative.
  3. I/we understand that I/we do not have to accept housing which is offered.
  4. As far as I/we know, the information on this form is true, and I/we will inform the co-operative of any changes.
  5. I/we understand that the co-operative has the right to regain possession of housing obtained if I/we have given false information.

Your information will be used to consider your application. Read the information about our online forms before you submit. The paper form says that receipt of applications will not be acknowledged; successful submission does not mean an offer of housing.

Type your full name below to record your declaration. The office may ask you to sign the paper form.