Abound Communities Independent & Assisted Living Application Form

Waitlist Times

Please note that some of our Villages have extensive waitlist times. If you require accommodation sooner, please consider putting yourself on the waitlist for one of our other sites. The average waitlist times for our sites are below:

Rushall Park (Fitzroy North): 10+ years waitlist time
Leith Park (St Helena): 5-7 years waitlist time
Currie Park (Euroa): 1.5-2 years waitlist time
Braeside Park (Berwick): 3-7 years waitlist time

Eligibility Criteria

Must have lived in Victoria for at least 20 years (proof of residency may be required)
Able to live independently (for Independent Living Units ONLY)
Of pensionable age (60+)

Please specify if you are currently ready to move in, or not ready yet *

ReadyNot ready

I am interested in the following type of accomodation *

Assisted LivingIndependent Living

I wish to apply for Assisted Living at the following site *

Rushall Park (North Fitzroy)Braeside Park (Berwick)Currie Park (Euroa)

Please note, you may select more than one option.

I wish to apply for Independent Living at the following site(s) *

Rushall Park (North Fitzroy)Braeside Park (Berwick)Leith Park (St Helena)Currie Park (Euroa)

Please note, you may select more than one option.

Date of application *

I am making this application as a: *

SingleCouple

First Name: *

Last Name: *

Email Address: *

Phone Number: *

Birthplace *

Date of birth *

Spouse First Name *

Spouse Last Name *

Spouse Date of Birth *

Applicants Address *

Street address *

City *

State *

Postcode *

Have you always lived in Victoria? *

YesNo

If no, what year did you arrive in Victoria?

Have you retired from paid employment?

YesNo

Pensioner Status?

Full Pensioner Part Pensioner Non Pensioner

Pension type

AgedVeterans Affairs DVA Gold Card

What are your reasons for seeking accommodation with Abound Communities? *

FinancialSocialSecurityOther (please specify below)

(Please select one or more options if they apply to you)

Please specify

How soon would you be needing this accommodation? (vacancies permitting) *

ImmediatelyWithin the next 12 monthsWithin the next 5 yearsNot for 5 or more years

What are your current living arrangements? *

In your own home or unit In a family member’s homeIn a home or unit that you rentOther (please specify below)

Rent paid per month? *

Please specify other living arrangement *

Please list the Home Care services you currently receive.

Are you interested in hearing about Abound Communities’ Home Care services and the advantages of having your support close at hand? *

Yes NoUnsure

Assets

Please provide an estimate of your assets, including residential property and total debts and/or mortgages. Please put $0 for any assets you do not have.

Residential property *

Total of any debts or mortgages *

Other property *

Superannuation entitlement *

Bank Accounts *

Shares *

Investments/other *

TOTAL ASSETS *

I declare that the above information is true and correct to the best of my knowledge. *

Draw signature|Type signatureClear

Signature Date *

Next of Kin Information

First Name *

Last Name *

Address

Street address

City

State

Postcode

Phone Number *

Email *

Relationship to applicant *

WE WOULD LOVE TO KNOW MORE ABOUT YOU

Please tell us the main reason for wanting to join our community. *

Do you know anyone here already? Do you have any family/friends living nearby? *

What sort of work have you done in the past? Are you still working? (You can still join our Community if you are.) *

What are your interests/hobbies? *

What do you think you can bring to our community? *

IMPORTANT INFORMATION

Please download and read the Disclosure Statement and the Fact Sheet relevant to the Village you are applying to.

Disclosure Statement

Currie Park Fact Sheet

Leith Park Fact Sheet

Braeside Park Fact Sheet

Rushall Park Fact Sheet

I confirm that I have downloaded and read the relevant fact sheet for the Village I am applying for. *

Comments:

Application Fee

A $100, non-refundable fee is required to confirm your application. If you are experiencing financial hardship and are unable to pay this fee, please call us on 03 9481 9300.

$100 Non-refundable Application Fee *

Pay

Save and Complete Later

Thank you for your application. We will be in touch with further information within the next five (5) business days.

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