Application form

In order to qualify for a tenancy, you must fulfil the following criteria:

You must have been a member of the Armed Forces or Emergency Services.
You must live in Derby or Derbyshire or have a connection with Derby or Derbyshire. Example are those who have served with a Derbyshire Regiment, or have a family member living in Derby or Derbyshire.
You must have a disability

Please fill in the entry form opposite.

If you are eligible for a place in The War Memorial Village we'll send you a further form via email that asks for more in-depth information about your current situation.

When you receive this second form, please it print out, complete it and send it back to us in the post.

We look forward to receiving your application.

Derby Homes will receive and assess all applications.

Please enter your title

Please enter your first name

Please enter your last name

Is there a second applicant? If so, please state relationship to main applicant

Please tell us your relationship to the main applicant

Please enter your telephone number

Please enter your email address

If you are not currently living in Derbyshire please state what local connection you have to the area.

Please enter what connects you to the Derbyshire area

Are there any other people you wish to be
rehoused with?

Please let us know if there are any other people

I have read and agree with the privacy policy. I understand that you will process my information in line with my application and that you will contact me in the future regarding this application.

You must read and agree to the Privacy Policy to continue