PGS Homeowner Application - SUPPORTMATCH HOMESHARE

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PGS HOMEOWNER APPLICATION

PRIVATE/CONFIDENTIAL: By completing and submitting this Property Guardianship Service (PGS) application you are agreeing to our Terms and Conditions

IMPORTANT INFORMATION

SUPPORTMATCH HOMESHARE DOES NOT CHARGE ANY FEES FOR REGISTERING AND SUBMITTING YOUR APPLICATION. SUBMITTING AN APPLICATION IS COMPLETELY FREE!

GUARDIANSHIP PROPERTY CHECKLIST

Note: Not all requirements are mandatory)

Are you the Property Owner:*
Yes
No

If you are not the property, do you have permission from the Homeowner to offer a room to a Guardian:*
Yes
No
Other

Is the property a HMO or Selective Licence:*
Yes
No
Not Applicable
I Don't Know
HMO: House Of Multiple Occupancy

Do you have a valid Gas Safety certificate for this property?*
Yes
No
Don't Know

Can you supply a working smoke and carbon monoxide alarms?*
Yes
No
Don't Know

Are all the electrical appliances and plug sockets safe and compliant?*
Yes
No
Don't Know

HOUSEHOLDER PERSONAL INFORMATION

First Name*

Last Name*

DOOR BUILDING Number or Name*
Door, Building Number and/or Name

STREET/ROAD NAME*
Street/Road Name

CITY TOWN*
Postal City/Town

POST CODE*
Example: W1T 6EB

TELEPHONE*

EMAIL*

DATE OF BIRTH*
DD/MM/YYYY

GENDER*
MALE
FEMALE
OTHER

Do You Agree to Provide Support&Match CIC to with a BASIC DBS CHECK:*
YES
NO
We can help you with acquiring a BASIC DBS Certificate if you don't have one.

ACCOMMODATION OFFERED

Room Occupancy Preference:*
Single Person
Couples
Single Person or a Couple

What is the Size of the Room you would like to offer to potential Property Guardians?*
SINGLE ROOM
DOUBLE ROOM
SELF-COUNTAINED ACCOMMODATION

Description of the Accommodation on Offer (Please Select):*
Own Bathroom
En-suite Bathroom
Standard Bedroom Furniture (Bed, Wardrobe, etc...)
Work, Study Desk

How Many Bedrooms Would You Like to Offer:*

Amount You Would Like to Receive Each Month For the Accommodation Offered:*

Description of Self-Contained Accommodation Offered (Please Select):*
Single Bedroom
Double Bedroom
Bathroom
Living Room
Kitchen
Basic Bedroom Furniture
Standard Living Room Furniture
Other Not Listed

Do you have Internet Access or can you provide Internet Access at the property?*
YES
NO

If there is an Outdoor space, will the Guardian be Granted Access:*
YES
NO
NOT APPLICABLE (No Outdoor Space)

Do you have any pets?*

Would you consider someone that has a pet?*

Please provide a copy of your ID and two documents for your proof of address:
CLICK TO UPLOAD
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(You can provide this information after you you have completed a registration call with a Supportmatch Homeshare Coordinator)

Once your application has been submitted we will ask you to send pictures of the accommodation you are offering. This can be emailed to us separately to
admin@supportmach.co.uk

Please Note: Guardians are full-time employees or mature students who will be able to offer you a maximum of 3 hours per week of help in their spare time in exchange for affordable accommodation. This help and support is generally domestic help, help with keeping appointments, companionship and of course overnight security.
You will also additionally benefit by receiving a regular monthly payment for the accommodation you provide to your chosen Guardian.

OTHER INFORMATION

If you are applying on behalf of someone else please complete the section below:

Friend/Family Full Name

Friend/Family Full Address

Friend/Family Email

Friend/Family Telephone

Relationship to the Householder

How did you hear about Supportmatch*

If you wish to provide further information with regards to the accommodation or yourself please use the box below*

I THE APPLICANT HEREBY AGREE*
To respect and abide by the Support&Match CIC Guardianship Licence Agreement and Terms & Conditions of Service
Agree to pay a reasonable monthly management fee to Support&Match CIC for arrangement-related monitoring and management. Support&Match CIC will manage the collection and payment of the Guardianship Licence fee to you, the Householder. Our service fee will be deducted monthly from the total Guardian Licence Fee on your behalf, with the remaining balance paid to you monthly as per the agreed terms and conditions of the Guardianship Arrangement.
For Support&Match CIC to record my personal data for office use only
I have understood the above information and that the information I have provided is correct.
I declare that I have no unspent convictions.
I have read, understood, and accept theses Terms of Service as stated in this application.
Information
Supportmatch Homeshare recommends that all Householders and Homeowners check with their mortgage and Insurance Providers to ensure the Homeshare/Guardianship arrangement does not affect either their mortgage and/or insurance policies. Please contact a Supportmatch Homeshare Co-ordinator on 0203 633 6066 or emailing admin@supportmatch.co.uk if you would like to discuss this or your application further.
Registration Date
APPLICATION TYPE (Admin)