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Croydon Staying Put, Home Improvement Agency
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Application form for private home owners and private rented tenants only
Tenure*
Owner Occupier
Private Tenant
Please give details of the person occupying the home requiring work.
Contact details
Title*
Please select
Miss
Mr.
Mrs.
Ms.
Not stated
First name*
Last name*
Contact number
Email
(If you enter your email address you will receive an email summary of the information you have submitted)
Contact address
Postcode
If you have a CR0 postcode please use the number zero not the letter O
Address*
Town
Postcode*
Personal information
Date of birth
Do you live alone?
Yes
No
How long have you lived in your home?
Years
Months
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