TENANT PROFILING – NEW TENANCY FORM
We want to provide our tenants with the best service possible so it’s important that we
learn about our tenants and understand their needs. To help us do this, please answer
the following questions. Your answers are kept in the strictest confidence
Address:
YOU
JOINT TENANT
(Other 1)
Title
First name
Surname (family name)
Date of Birth
National Insurance Number
Tel Number
Mobile no
e-mail address
Preferred language
Relationship to Main Applicant
Other Members Of The New Household:
Forename
Surname
Relationship To
You
DOB
NI
Other 2
Other 3
Other 4
Other 5
Other 6
Other 7
Other 8
Other 9
HOW MANY CARS ARE THERE IN YOUR HOUSEHOLD?
1
Disability & Physical Adaptation
Does anyone on the application have a medical issue or disability
that will affect their housing needs?
YES 
NO 
Will any minor adaptations be required at the new property?
YES 
NO 
If yes, please give details: ………..……………………………………………………………
Disabilities. Does anyone in the household have any disabilities or long term illnesses that
limits their daily activities or affects the type of house you need?
You
Other
1
Other
2
Other
3
Other
4
Other
5
Other
6
Other
7
Other
8
Wheelchair User
Difficulty Walking
Visual Impairment
Hearing Impairment
Learning Disability
Mental Health
Drug Related
Speech Impairment
Oxygen Therapy
Dialysis
Seizure Disorder
Suppressed Immune System
Alcohol Related
Prefer Not To Say
Other
2
Other
9
Is there anything else you need to tell us about how illness/disability
affects the type of house you need?
YES 
NO 
If yes, please give details:……………………………………………………………………………….
…………………………………………………………………………………………………………………
………..……………………………………………………………………………….
.
Language & Accessibility
Can you and all the other members of your household communicate in English?
(Please enter Y = Yes or N = No)
Speak
English?
Read
English?
Write
English?
You
Other 1
Other 2
Other 3
Other 4
Other 5
Other 6
Other 7
Other 8
Other 9
If you cannot communicate in English, please tell us what your preferred language
would be.
………………………………………………………………………………………………
………………………………………………………………………………………………
3
Do you need our information in any other format? (pls tick as many as apply)
JOINT APPLICANT
(Other 1)
YOU
Large Print Letters / Leaflets
Information on CD / Audio Tape
Welsh Language Letter / Leaflets
Translator
Sign Language
Braille
Hearing Loop
Support With Literacy / Numeracy
Any Other:
Employment & Income
What best describes the circumstances of each member of the household?
You
Other
1
Other
2
Other
3
Other
4
Other
5
Other
6
Other
7
Other
8
Employed Full Time
Employed Part Time
Self Employed
Gov. Supported Training
Full Time Education
Pre School
Unemployed, Avail for Work
Permanently Sick/Disabled
Looking After Family At Home
Retired
Doing Something Else
4
Other
9
What is your household’s main source of income?
Please tick one
Salary
Out of work benefits
Disability benefits
Universal Credit
In work benefits
Pension
Savings
Other (please specify)
What is your average house hold income either per week OR per month?
Please tick one
Up to £99 per week
£100 - £199 per week
£200 - £299 per week
£300 - £399 per week
£400 - £499 per week
£500 - £599 per week
Less than £429 per month
£430 - £864 per month
£865 - £1,299 per month
£1,300 - £1,729 per month
£1,730 – £2,164 per month
£2,165 – £2,599 per month
5
BANK ACCOUNTS & INSURANCE
Do You Have Any Of These Accounts? (please tick)
YOU
JOINT APPLICANT
(Other 1)
YOU
JOINT APPLICANT
(Other 1)
Bank Account
Building Society Account
Credit Union Account
Post Office Account
Other
DO YOU GET HOUSING BENEFIT? (please tick)
Yes
No
DO YOU HAVE HOME CONTENTS INSURANCE? (please tick)
YOU
JOINT APPLICANT
(Other 1)
Yes
No
6
Direct Debits & Other payments
Yes
No
Other
7
Other
8
Do you use Direct Debit to pay your bills?
Do you normally have money left at the end of the week/ month?
Do you have any debt (e.g. loans / credit cards / catalogues etc.?)
GETTING INVOLVED
Would anyone in your household be interested in any of the following?
You
Other
1
Other
2
Other
3
Other
4
Other
5
Other
6
Jobs/Training Through UW
Volunteering
Time Banking
Becoming A Board Member
Joining A Residents Group
Help Improve Our Services
Help To Manage Money
HOW WOULD YOU LIKE TO CONTACT US? (please tick)
YOU
JOINT APPLICANT
(Other 1)
By Phone – Using our free-phone number
By Phone – Using our main switchboard number
By Phone – Using a direct number
By Text
By Email
Via Our Website / Social Media
7
Other
9
Via Our Digital TV Channel
You Visit Us - At our Caerphilly office
You Visit Us – At our Cardiff office
We Visit You – At your home
At An Estate Event
Through A Support Worker
HOW WOULD YOU LIKE US TO CONTACT YOU? (please tick)
YOU
JOINT APPLICANT
(Other 1)
By Phone
By Text
By Email
By Letter / In Writing
Via Newsletters / Magazines
Via Our Website
Via Social Media / Facebook
We Visit You At Home
Via Residents Groups
Via Open Meetings / AGM’s
8
THE INTERNET & DIGITAL DEVICES
Do You Have Internet Via Any Of These Devices? (please tick)
JOINT APPLICANT
(Other 1)
YOU
Mobile Phone
Tablet
Computer / Laptop
Games Console
Television / Blu-ray Player
Public Computer (Library etc.)
UW Office / Scheme Computer
Yes
No
Do you use the internet regularly? (please tick)
If you don’t have access, please tell us why? (please tick)
YOU
JOINT APPLICANT
(Other 1)
Don’t know how to use but would like to learn
Don’t know how to use and don’t want to learn
Internet access at home too expensive
Devices are too expensive
Other
9
EQUALITY & DIVERSITY
We are obliged by the Government to collect equality and diversity data for all of our
tenants. There are some sensitive questions but your answers are treated in the strictest
confidence. You don’t have to answer any questions you are not comfortable with.
RELIGION. Please tell us the religion of each member of your household
You
Other
1
Other
2
Other
3
Other
4
Other
5
Other
6
Other
7
Other
8
Other
9
Atheist
Buddhist
Christian (including Catholic)
Hindu
Jewish
Muslim
Sikh
None
Prefer Not To Say
Other please specify
………………………………………………………………………………………………………
………………………………………………………………………………………………………
ETHNICITY. Please tell us the ethnicity of each member of your household
You
Other
1
Other
2
Other
3
Other
4
Other
5
Other
6
Other
7
Other
8
White – Welsh
White – British
White – Irish
White – European
White – Other
10
Other
9
Mixed – White & Black
Caribbean
Mixed – White & Black African
Mixed – White & Asian
Mixed – Welsh
Mixed – Other
Asian/Asian British – Indian
Asian/Asian British – Pakistani
Asian/Asian British –
Bangladeshi
Asian/Asian British – Chinese
Asian/Asian British – Welsh
Asian/Asian British – Other
Black/Black British –
Caribbean
Black/Black British – African
Black/Black British – Welsh
Black/Black British – Other
Gypsy / Traveller
Prefer Not To Say
11
EU STATUS. Please tell tick the most appropriate option for each member of your household.
You
Other
1
Other
2
Other
3
Other
4
Other
5
Other
6
Other
7
Other
8
Other
9
Other
8
Other
9
UK National & UK Resident
UK National returning from
residency overseas
EU National
Non EU National
Not Known
Prefer Not To Say
SEXUAL ORIENTATION. Please tell us for all those in the Household over 16yrs old
You
Other
1
Other
2
Other
3
Other
4
Other
5
Other
6
Other
7
Heterosexual (straight)
Bi-sexual
Gay Man
Lesbian/Gay Woman
Don’t Know
Prefer Not To Say
12
GENDER IDENITY. Please tell us for all those in the Household over 16yrs old
You
Other
1
Other
2
Other
3
Other
4
Other
5
Other
6
Other
7
Other
8
Same gender as you were
given at birth
Different gender to that given
at birth
Don’t Know
Prefer Not To Say
Thank you. Your answers will help us make sure that our services are fair and
open to all
13
Other
9