Crisis Grant

IMPORTANT – This is the Crisis Grant Application Form and NOT the Covid-19 Emergency Application Fund form.
If you have been affected by the Coronavirus and wish to apply for the Covid-19 Emergency FundCLICK HERE

Grant Application Form

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Page 1

PART ONE: APPLICANT'S PERSONAL INFORMATION

dd/mm/yyyy



Postal Address

PERSONAL INFORMATION

Information gathered in this section will not affect your application.  It is taken for demographic reporting only.  It is not accessible to the assessors considering applications.

Page 2

PART 2: CARE SECTOR EMPLOYMENT

This part of the application asks for details of your paid employment in the UK's social care sector. Your work must be involved in or support the provision of care. To be eligible, you must be either:


         Currently employed in the care sector with at least one-year service.


         Previously employed in the care sector for at least 5 years.

Stop

If you have been formally disciplined for patient endangerment, please stop your application and email
grants@thecwc.org.uk

Most Recent Care Sector Employment 

dd/mm/yyyy
dd/mm/yyyy

Previous Care Sector Employment 

Page 3

PART 3: HOUSEHOLD INCOME AND SAVINGS

Household Make Up


BENEFIT ENTITLEMENTS

Applicants need to have checked their entitlements to means tested benefits using the details of their current financial circumstances before their application can be considered. 


This can be done by completing a calculation report using the Turn2Us Benefits Calculator or by contacting the Turn2Us helpline (0808 802 2000, 9.00am-5.30pm, Mondays – Fridays).


INCOME

We may request additional information or documentation to support the income list below in order to process your application. Please declare your monthly household income.

MONTHLY EXPENDITURE

SAVINGS

DEBT


Banking Information
Please provide banking details.  This will make it easier for us to pay your grant quickly if you are successful.

If you are requesting support with a whitegood or household item, you may skip this section.
Please just enter the numbers without spaces or dashes
Please just enter the numbers without spaces or dashes

Page 4

PART FOUR: CIRCUMSTANCE AND NEED

Please select the following circumstances that you have experienced in the last year that have had significant financial impact.  You may select multiple circumstances.


For each circumstance that you select, please detail when the event occurred and the financial impact.





DESCRIPTION OF NEED

Below are some common costs that we can support:

  • Daily Living
  • Bankruptcy/DRO fees
  • Car Repairs
  • Funeral Costs
  • Health Improvement Aids
  • Home Repairs
  • Household Items
  • Moving Costs
  • Preventing Eviction
  • Travel Expenses
  • Whitegoods

Please note that our maximum grant amount is £500 and the maximum for daily living is £250. Payments will be made for the third parties when possible. White goods and household items are selected by CWC and fulfilled by our business partners with items delivered directly to the grantee.

Second Area of Need

PART FIVE: SUPPORTING DOCUMENTS

       MANDATORY: Proof of your employment history in the care sector (one document)

o   Recent payslip

o   P60 form

o   P45 form

o   Confirmation letter from your employer stating your period of employment

o   Termination letter

      MANDATORY: A letter of support

o   This should be a letter supporting your application from a professional who is aware of your circumstances and can explain what the grant is paying towards and difference the grant will make.

o   Examples of acceptable sources:  housing support worker, doctor, debt advisor, manager at work or an agency such as the Citizen’s Advice Bureau.

o   The letter should be signed and on headed paper.

o   This letter should NOT be from a friend, family member, or co-worker.

        

       

     You will need to provide the relevant supporting documents based on the circumstances you selected:


      Illness or Injury:  Medical confirmation 

o   SSP stating time off work due to health issue.

o   Medical letter confirming the condition.

o   Mobility aids need to be recommended by a medical professional.

o   If you are requesting a grant to pay towards home adaptations due to disability, you must have applied for a Disabled Facilities Grant and have a recent occupational therapist’s letter recommending the adaptations.

       Repair Costs: Two Contractor Quotes

       Preventing Eviction: Proof of Eviction Proceedings

       Bankruptcy or DRO Requests: Letter from a Debt Advice Specialist

       Moving Costs:  New tenancy agreement

       Domestic Violence: Letter from a domestic violence support organisation

       Funeral Costs:  Funeral bill



If you are unable to upload your documents, please send your supporting documents:

·      By email:  grants@thecwc.org.uk

By post:  The Care Workers Charity (Grants), Vox Studios, West Unit 107, 1-45 Durham Street, London SE11 5JH


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PART SIX: OTHER POTENTIAL SOURCES OF HELP

We may be able to identify further help for you from other organisations. Additional occupational benevolent funds are a potential source of financial help.

PART SEVEN: REFERRING SOURCES

PART EIGHT: CARE QUESTIONNAIRE AND EQUALITY AND DIVERSITY MONITORING

This questionnaire is optional and will not be factored into the grant assessment.

 

Information gathered in this section helps CWC increase our understanding about the ways we can improve the services we offer. Your responses will be anonymised.








PART NINE: CASE STUDY INFORMATION

Case studies are an important way in which we raise awareness of CWC and illustrate the positive impact of our work. It also helps our fundraising efforts, which enables us to grow and help more people.

 

Participation in the case studies is optional. Your decision will not be factored into CWC’s grant assessment.

 

PART TEN: CONSENT AND DECLARATION

CONSENTS

Your information will remain confidential and only be held or disclosed to assist with your application. The Care Workers Charity processes personal data in accordance with the General Data Protection Regulation and you have a right to request access and/or erasure of your personal data. Please refer to our Privacy Policy to learn more about how and why we use your information.