Application Form for a Free Home Safety Fire Check
Isle of Wight Council
Application Form for a Free Home Safety
Fire Check
Community Safety,
South Street, Newport, Isle of Wight, PO30 1JQ
All fields marked with a * are required entries.
The Isle of Wight Fire and Rescue service offer free to local residents Home Fire Safety Checks. These checks give advice to residents on general fire safety awareness, smoke alarms and escape routes.
Please note: We do respond to all requests for the Home Safety Fire Check, but we prioritise and target groups that our data identifies as being those considered to be at higher risk from accidental dwelling fires. Groups consistently targeted for Home Fire Safety Checks are single parent families, the elderly and people living in 'homes of multiple occupations'.
Applicant's Details
Title
*
Forename
Middle name/Initials
*
Surname
*
Building/house name/number
*
Street address
*
Town name
County
*
Postcode
Telephone number
(include area code)
Email address
Fax
Property Details
Please select your ownership status of property
Owner
Tenant
Student Accommodation
Shared Tenancy
Other
If 'other' above, please give details
Type of property
Business
Hotel
Residential Home
Halls of Residence
House
Bungalow
Caravan
Flat(s)
Other
If 'other' above, please give details
Describe the occupants living in the property
Family
Single Parent Family
Elderly Couple (over 60 years old)
Elderly Living Alone (over 60 years old)
Multiple Occupants
Living Alone
Other
Declaration
*
I hereby confirm that the details given in this form are true and correct to the best of my knowledge and I am the named applicant.
Signed ...............................................................................
Name.................................................................................
Date...................................................................................
Data Protection Act 1998
This application may be monitored by the Isle of Wight Council for regulatory, quality control or crime detection purposes. Information from this application will be processed in accordance with the Data Protection Act 1998 for the purpose of processing your particular enquiry/request. The Isle of Wight Council ("the Council") is the data controller. By completing this form you consent to the Council contacting you by email or nominated contact method in relation to your enquiry/request.
The information contained in this application may, in exceptional circumstances, be subject to disclosure to third parties under either the Data Protection Act 1998 or the Freedom of Information Act 2000 to the extent the law allows and in accordance with the Isle of Wight Council's
Access to Information Policy
. Disclosure will only be made where in all the circumstances it would be fair to do so and in the public interest.
Please note that the Council may process your information in the absence of consent for the purpose of crime prevention or detection so far as is in accordance with the law.
Sometimes we may use your information to keep you informed about services, goods or relevant issues that we believe may be of interest to you. If you wish to receive this information for these purposes please tick this box
To improve the quality of other services that we provide to you the Council wishes to hold your non-sensitive personal information on a secure central database. This will enable all Council services to use this information when they are providing a service to/for you. If you wish your non-sensitive personal information to be held by the Council please tick this box
Date printed: 07/03/2013