Application and Occupancy Agreement
This house is for people or families who may need a place to stay while they are receiving medical treatment, or supporting a family member while they are in hospital. It is intended for short stays only.
Sometimes people can also use Winsome's Place when visiting from interstate to attend funerals, conferences or rallies, or attending court appearances or visiting relatives in detention.
The maximum time of your stay is two weeks. You must have permission from Winsome’s Place case worker if you think you might need to stay longer.
While you are staying in Winsome’s Place, there are some things you must do:
• Pay rent for the room you are staying in
• Look after the house and property, and not deliberately cause any damage to it
• Keep to the ‘House Rules’ rules outlined below
TERMS AND CONDITIONS
We will charge you $15.00 per room, per night to stay at Winsome’s Place. You can pay by cash or direct deposit to our bank account, but we don’t accept personal cheques. We will give you a receipt for the money as proof of your payment.
TERMS OF OCCUPANCY
Please be aware that when you submit this form you are deemed to be agreeing that you have read and agree to the terms of occupancy and house rules.
The terms of occupancy are legally binding so please read them carefully. At the end of the form you can add your email address to get your own copy of this agreement.
There may be another person or family staying at Winsome’s Place at the same time as you. You must treat each other with respect. To help you understand what respecting each other means, please read the ‘House Rules’ that form part of your agreement of staying at Winsome’s Place:
PLEASE READ THE HOUSE RULES CAREFULLY
Please remember that when you submit this form you are deemed to be agreeing that you have read and agree to the house rules.
WINSOME'S PLACE - HOUSE RULES
• No smoking inside the house
• Clean up after yourself
• Dispose of rubbish in rubbish bins and take the bins out for weekly garbage collection
• Keep the house and yard, furniture and other items already in the house in the same condition as it was before your stay.
• We don’t let people bring animals into the house. If you do have an animal with you when you need to stay, talk to the EveryMan caseworker first.
• Leave all the furniture and other items provided in the house there when you go.
• Tell the caseworker straight away if any of the items in the house break, or are damaged in any way.
• Keep the caseworker informed of why you want to stay and for how long.
• Let the caseworker attend the property as needed
• Do not cause, or let anyone else visiting you cause disturbance on the property, such as being aggressive, threatening or disruptive towards anyone, including other visitors, neighbours and EveryMan staff.
• No keeping, trading or using any illegal substances on the property.
• No illegal activities on the property
Rights and Responsibilities of EveryMan
• To keep a set of keys to the property
• To have access to the property to carry out routine checks and inspections
• To respect Occupants' privacy needs
• To balance Occupants' needs for privacy and independence, duty of care around Occupants' support and safety needs and Workplace Health & Safety obligations to our staff
• Undertake general upkeep and maintenance to keep the property in a liveable state
PLEASE READ THE TERMS OF OCCUPANCY CAREFULLY
Please remember that when you submit this form you are deemed to be agreeing that you have read and agree to the Terms of Occupancy.
TERMS OF OCCUPANCY
• I understand that I will have to repay EveryMan for damage if I haven’t met the responsibilities that I have agreed to.
• I have contacted the Winsome’s Place caseworker. They know I am staying here and how many people I am responsible for.
• I agree to pay the agreed amount of $15.00 per room, per night for the duration of my (and anyone accompanying me) stay.
• I will tell the Winsome’s Place caseworker if any of my plans about staying change.
• I will give back all keys to the property that were given to me, and understand I will have to pay for new locks to be installed if I don’t give them back.
• I will not disturb anyone else staying at Winsome’s Place. I understand I will be asked to leave if I do and that EveryMan will not refund any of the money I have paid to stay.
• I will not use or enter any of the rooms that have not been agreed for me to use.
• I will pay for replacement of any of the household items that become lost, damaged or unusable.
AGREEMENT TO TERMS AND CONDITIONS
I understand that by submitting this agreement, I am agreeing that have read and understand my responsibilities while staying at Winsome’s Place, including the House Rules, and will respect and comply with these rules, terms and conditions.
Date of Birth
Name/Age of additional guests
Date of Stay?
How many nights?
How many rooms?
$15 per night per room
Name of Service Referring
If 'other' give details:
Able to pay upfront?
If yes, by what method?
Usual home Address
Agree to provide own linen
No pets permitted at property
Agree to ensure clean house on departure
I understand that If I don't, charges for cleaning may be issued to me
Terms and Conditions
I understand that when I submit this form, I am agreeing to the conditions as described above.
(This is a required item - if you don't check this box, you will not be able to submit the form)
Yes, I understand
No, I don't understand and would like to talk to someone about it
Send me a copy of my responses
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