Application for Supported Accommodation

Before you begin:

Please read the information about the supported accommodation program on the Homes Tasmania website.
Assessment of applications may result in additional documentation or information being required. You will be advised if this is the case.

Contact us

Email: commissioning@homes.tas.gov.au

Application details

Housing support provider *(Required)

Contact Full-name *(Required)

Contact position *(Required)

Contact phone *

Contact Email *

Is your organisation a registered NDIS provider?

YesNo

Is your organisation registered with the Australian Charities and Not-for-Profits Commission?

YesNo

Date established:

ABN:

NDIS number:

Request for a new property

Residential accommodation – leased to eligible persons.

Proposed use *

Target client group *

Client name(s) - For NDIS providers

Supports to be provided

Funding source and amount

Property requirements

Number of bedrooms

Number of client(s)

Number of staff

Office space

YesNo

Other

Location

Property features

Other relevant information

Please attach any additional documentation as required

Browse

Upload any documents if applicable (PDF, DOC, JPG, etc.)

Upload another document (if applicable)

Browse

Upload any documents if applicable (PDF, DOC, JPG, etc.)

Upload another document (if applicable)

Browse

Upload any documents if applicable (PDF, DOC, JPG, etc.)

Declaration: To be completed by the Applicant

I have read and accept Homes Tasmania requirements as described in the accompanying Fact Sheet *

Full name

Date

Signature

Draw signature|Type signatureClear

Completed form

Applicants are encouraged to speak to us prior to lodging an application to ensure all details have been successfully completed.

The completed form, along with any supporting information, should be submitted via the email address below.

Assessment of applications may result in additional documentation or information being required. You will be advised if this is the case.

Captcha *

If you have issues submitting this form, please contact the Homes Tasmania team at commissioning@homes.tas.gov.au

For staff use only

Approved Declined

Delegate name

Date

Signature

Draw signature|Type signatureClear

Save and Complete Later