Complete this form if you are:
- In financial crisis or you are vulnerable - see examples of crisis
- A professional contacting us on behalf of a client.
By filling in the welfare support form, you may qualify for food support, energy vouchers and furniture packages.
You MUST complete all sections of the form including the income and expenditure section or your application will not be processed.
To complete this application form you will need:
- Your National Insurance number
- Contact details including an email address
- Details of money you and members of your household are receiving
- Details of your outgoings
- Details of your situation
To make a decision on your application we need you to complete this form with as much accurate information as possible. In some circumstances supporting evidence may be required, we will email you when we review your application if we need further information. Do not delay in providing this evidence as it may delay a decision if we need to contact you.
The information we are asking for in the application is there to help and support you so we can look at your circumstances and identify if you are entitled to any further support.
Before you apply
Before making a referral for welfare support, you will need to read the Local Welfare Support Policy and consider the following:
Reasons you may NOT be able to apply for welfare support
You cannot apply for welfare support if you:
- Are a Looked After Child being supported by the Local Authority e.g. private fostering
- Are applying because you have had your benefit disallowed (must apply to DWP Hard ship payments)
- Are applying because you are subject to a benefit sanction (apply to DWP Hardship payments)
- Are resident in a care home or other supported accommodation, unless there are plans for discharge within eight weeks
- Are a hospital in-patient unless there are plans for discharge within eight weeks
- Are lawfully detained unless there are plans for release within eight weeks
- Are a member of and are being maintained by a religious order
- Have applied for assistance with items for independent living in the last 28 days and there is no significant change in circumstances
- Have needs that can be met from another source, this includes if the Council has a statutory duty to meet an expense, e.g. a Disabled Facilities Grant under Section 24(1)(a) of the Housing Grants, Construction and Regeneration Act 1996, or under the provisions of Section 17 of the Children Act 1989; or if you have existing disposable income or capital.
Have you had your benefits stopped because of a sanction?
If so, you may be eligible for a hardship payment. Please contact your local Jobcentre Plus (external link) to discuss further. Our scheme does not cover this.
Are you eligible for a budgeting loan?
If you have received one of the following benefits for over 26 weeks, then you may be eligible for a budgeting loan.
- Income support
- Income-based Job Seeker’s Allowance
- Income-related Employment and Support Allowance
- Pension Credit
- Universal Credit customers can apply for advance payment by contacting their local Jobcentre Plus (external link).
- Find out more information about budgeting loans (external link) and apply online.
Complete the welfare support form