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This information will help WCC understand the accommodation available and discuss it with you. Only some information is mandatory, but the more you add, the more helpful it will be.
When (and if) you are ready, the social service agencies will receive a summary of the information without your contact details. This will enable them to suggest someone who fits the housing type and your preferences.
We will contact you for permission before sharing your contacts or address.
Thank you for taking the time to fill out the information.
Housing Availability Information Form
Summary Information
Location and Availability
Status of information
*
What is the status of this information?
Exploratory only
Tentative and considering
Ready to share with a social service agency
Housing is occupied at present
Unavailable for other reasons
Other
Address
*
Initially, only the Suburb is required; other details are useful but optional.
Address line 1
Address line 2
City/Suburb
State/Territory
Postcode
When will the rooms be available?
*
Please give the approx. month, year or say undecided.
Availability for a minimum of 6 months is recommended.
Rooms for sole use of lodger(s)
*
This does not include the kitchen and bathroom, addressed in the next questions.
One bedroom
One larger bedroom-lounge room
Two rooms
Three rooms
A separate property
Other (please explain below)
Preferred gender of lodger(s)
Female
Male
Other
Female or male
Any - I don't mind
Accomodation Details
*
Room(s) in your house
An annex attached to your house
Entirely separate granny or garden flat
Separate apartment or house (not where you live)
Caravan in your garden
Other (please explain below)
Bathroom
*
Shared with owners and/or their children
Shared with other lodgers
Private use for lodger
Other
Kitchen or kitchenette
*
Shared with owners
Shared with other lodgers
Private and in the lodger's living room
Private and separate from the living room
Other spaces the lodger(s) can use?
Can the lodger share any other spaces with you or other lodgers? for example, a lounge, the garden etc.
Entrance door
Will the lodger have their own entrance door?
Lodger will use same entrance as owner
They have their own separate entrance
They will use a door, sometimes but rarely used by the owner
Is parking available?
*
Yes, in driveway or garden
On the street
No parking nearby
Other
How accessible is the space?
Is it possible for someone with mobility challenges to live in the space?
Has some steps or stairs
Narrow doorways
The bathroom and/or kitchen are not fully accessible
The bathroom and kitchen are accessible
Is the accomodation furnished?
Yes (bed, beside table, clothes storage, table/desk and chairs, sofa etc)
Partially
Unfurnished
Is there access to public transport within walking distance?
Tick all that apply.
Bus
Train
Tram
Other transport options
Lodger Preferences
Tell us who you would feel comfortable staying with you.
Tick as many boxes as you wish.
Number of lodgers (tenants)
One person
Couple or two people
Couple with a child or two children
Other
Age preference
Any age
Young adults under 35
Middle age 35 -60
Older over 60
Are children welcome?
Yes to live
Yes to visit
Sorry, but no
Other (please explain below)
How do you feel about pets?
Possibly, depends on its type, behaviour, size etc
Yes, I like pets
Sorry, no pets
Willing to discuss
Other
Do you allow smoking or vaping ?
*
Sorry, but no
Yes, but only in the garden
Yes, inside and outside
Other
Would you like to help specific people?
Tick as many groups as apply
Single older women
Youths, young adults or students under 30
Low Income earners
Homeless people
Refugees and asylum seekers
Single parent with a child or children
Victims of family abuse
People with physical disabilities
People with mental health issues
Former offenders
Recently divorced or separated people
No preference
Are there other specific people you would like to help or have expertise to assist?
Your Information and Contact Preferences
Main contact person
*
First name
Last name
Main email address
*
Mobile phone number
*
Secondary Contact First Name
Secondary Contact Surname
Secondary Email Address
Preferred contact method
*
If we have to contact you, what method would you prefer?
Email
Text message
Phone call
Home phone or second contact mobile (if applicable)
Languages spoken, other than English
Referee1 First Name
Referee1 Last Name
Referee1 Email address
Referee1 Phone number
Referee1 type
Church Elder
Church leader
Employer
Manager
Mentor
Pastor
Teacher
WCC Volunteer or staff
Other
Finally, please add any additional information like you would like to provide to Whitehorse Churches Care.
Additional information
Next Steps
We are keen to answer any questions or queries you may have or provide you with information about house sharing. But we don't want to press you into a decision until you are ready.
Would you like WCC to contact you to discuss this information form or any related questions?
*
WCC is run by part-time staff and volunteers. We will get back to you as soon as we can, usually within a couple of working days.
Yes please, quite soon
Yes, but not yet
I will contact you when I need to discuss this further
No, thank you.
Please check the highlighted fields
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