Healthy Homes Assistance Grant application form

 
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The Healthy Homes Assistance Grant can help people who own their own home, private tenants, and tenants of social landlords (not council tenants) adapt their homes to meet the needs of disabled children and adults.

We are responsible for delivering this grant. If you have any questions, please call us on 01757 705101 or email privatehousingassistance@selby.gov.uk

Housing Grants, Constriction and Regeneration Act 1996 

The Housing Renewal Grants (Amendment) (England) regulations 2008

Please note - If you are filling out this application form on behalf of the person requiring the grant assistance, please complete this form with their details. 

Section 1 - Eligibility checklist

Please include name, agency and contact details

Details of the person(s) needing assistance 

Individual's details: 

Please provide your partner's details below. 

Section 3 - Details of property

Please provide the details of the type of tenure on the property. 

Section 4 - Types of work required 

Section 5 - Applying on behalf of someone else 

If you are completing this application for someone else who is requiring this assistance, please provide your details.

Declaration

WARNING: IF YOU KNOWINGLY MAKE A FALSE STATEMENT, YOU MAY BE LIABLE TO PROSECUTION

 

I/We declare that to the best of my knowledge information and belief, the information I/We have given above is correct. I am: [the applicant] [one of the applicants] [the relevant person (but not the applicant or one of the applicants)] [a relevant person (but not the applicant or one of the applicants)].