Cancelling your housing application

Who is this form for?

Please use this form to let us know that you want to cancel your housing register application.

Protecting your personal data

By completing this form you acknowledge that we will follow our responsibilities under data protection legislation. We will store the information securely, share it with partners and other statutory agencies where we have the right under law to do this, use it only for the purpose it was provided and process it as set out in our privacy policy. For more information please see our privacy policy on our website www.berneslaihomes.co.uk
  • 1. Your Personal Details
  • First Name *

  • Last Name *

  • Address *

  • Home phone number

  • Mobile phone number

  • Email

  • Your application reference number *

  • You can find this on your registration letter or card. If you do not know this then please contact us on 01226 775555 and if you can answer some security questions then we will let you know the number.
  • Date of Birth *

  • 2. Cancelling your application
  • Why do you want to cancel your application *

  • If other, what was the reason?

  • 3. Confirmation
  • I confirm that I am the housing register applicant, all of the above information is correct and I understand that my application will be cancelled.