FORM TEST COMMUNITY FUND

The Community Living Fund is only open to tenants of MCC Housing services (Formerly Northwards Housing).

Tick this box to confirm that you ARE a tenant of MCC Housing Services:

If you are applying on behalf of a tenant you are working with please complete the following information:

I want to make an application for:

Are you applying for yourself?

If you are the only person living in your household, tick this box:

I have a partner:

Yes

How many Children under the age of 16 do you have living with you?

How many children between the age of 16-18 do you have living with you?

Other than your partner, how many other adults live with you?

Does anyone in your household have a physical or mental illness/disability lasting or expect to last 12 months or more?

Yes