Fields marked with an * are required Contact Information Contact Information I am applying for an almshouse For myself For a friend or relative Your name (if you are applying for someone else) Email contact for this application Phone or postal address (if you do not have an email account) About the Applicant(s) About the Applicant(s) Number of Applicants * I am applying for single occupancy I am applying for occupancy with a spouse or partner Name(s) of applicants * Age(s) of applicants * Do you currently reside in the City of Worcester? * Yes No Please can you provide a brief explanation of your current living situation? * Please include any medical conditions or additional care requirements we should be aware of. * Any additional information you would like to include in your application. If you are a human seeing this field, please leave it empty.