Download the form by clicking on the button opposite. The form can be printed and completed by hand or alternatively by typing into the PDF.
Guidance notes for completion of application forms
- Please complete EVERY section of the form clearly and with as many details as possible.
- If full financial details or other essential information are not completed, the application form WILL BE
- The application MUST BE endorsed with a supporting statement by a professional working to support the individual/family. The statement may be continued onto another sheet: it is important that the Trustees have as much information as possible to help them understand and consider the request for assistance.
- When returning the form, YOU MUST attach quotes for the specific items requested. For electrical items we suggest you obtain quotes from Economy Cookers or Cooper & Elms as we have found them to be reasonable and reliable suppliers offering good value for money. For carpets we have found that the Derwent range is a decent quality carpet at a reasonable price and applications for that range or similar will be considered. Please ensure that all carpet quotes state cost per square metre.
- When seeking financial assistance for more than one item, or for the carpeting of more than one room, please rank each item requested in priority order.
- On completion, the form (and any additional information and quotations) should be returned, marked ‘Private and Confidential’ to:
The Secretary, King’s Lynn and West Norfolk Borough Charity, Bank House, Middle Drove, Marshland St James, Norfolk PE14 8JT
Or by email to: email@example.com
- The Secretary can be contacted on 07595939769 or at firstname.lastname@example.org with any queries.
- For further guidance, please see ‘Frequently Asked Questions’