Applications for Funding

Christine Masson: 01224 558580

Eligibility Criteria (updated 04/05/2016)

  1. All applications must be made electronically by using the form below. Once filled in, click on the "submit" button which you will find at the bottom of the page.
  2. There must be funds available.
  3. Funding cannot be provided by another source. Details of where you have applied must be noted on application form.
  4. Funds must be used for a crisis situation. Health Visitors please note - vouchers only last one week from date of issue. If they are not used within this time frame, it suggests there is not a crisis, and they cannot be reissued. They can only be used at the Bridge of Dee branch of ASDA.
  5. Funds must directly impact on the health and/or well being of the child.
  6. Funds must directly impact on the education of the child.
  7. Decisions are made on the basis of prioritization using the information provided, therefore more precise information will improve the chances of your application being successful.
  8. Decisions are made by two Directors of the Charity.
  9. Recipients must be under 5 years of age and live within Aberdeen city.
  10. If applying for clothes please specify items required, as this allows us to calculate cost.
  11. Unsuccessful applications cannot be resubmitted at a later date.
  12. We have secure systems in place to ensure confidentiality of information submitted to us, and sensitive data is automatically deleted from our remote systems within one month.

Please take care to fill in all the form fields after reading the information at the right hand column regarding the ways in which we can help. Thank you.

Section 1: Parent's Details

First name Surname  
Address:
Telephone number

Section 2: Children Details (only for those who are under five years)

No of children under 5 years in the home?
FIRST CHILD
1st child, first name 1st child, surname  

M/F

1st child DOB dd/mm/yy
SECOND CHILD
2nd child, first name 2nd child, surname  

M/F

2nd child DOB dd/mm/yy
THIRD CHILD
3rd child, first name 3rd child, surname  

M/F

3rd child DOB dd/mm/yy

Section 3: Health Visitor's Details

If you are not the Health Visitor, but applying on behalf of a HV, please give your name, job title, place of work:
HV First name HV Surname  
HV Work place   HV Telephone number
HV e-mail HV NMC reg.no

Section 4: Eligibility

Using the eligibility criteria above, please answer the following questions:-
(Please note decisions are based on the information you provide)

What social factors have caused the crisis situation?

Where / to whom have you applied for funds and been rejected?

Why can't the family afford these items:

How will the funding improve the lives of the child/children?

If you are applying for more than one item, prioritise them by listing the most important things first!

If the application is for clothes or shoes, please specifically list the items you wish the child to have as this helps us to give sufficient funds to cover the cost.

If this application is for equipment please specify the item or items required:

Section 5: Testimonials

The reason we ask for testimonials are
  1. To provide evidence in support of applications to larger bodies for funding.
  2. As evidence that funds are being used in compliance with the regulations of the  OSCR and the constitution of The Broomhill Nursery Charity.

Testimonials should be the Health Visitor’s professional assessment of why the funds are required and the needs that will be met.
(You might choose to use the Shanarri Indicators).


Section 6: Health Visitor's Signature

Click on the purple link below to print out the Client's Permission for Referral slip

Client's Permission for Referral Slip (Compulsory)

We would suggest that it might be a good idea for the Health visitor to have some of these printed out and carried with her at all visits to cut out the need to return to the client for their signature at a later date.

Please note that no applications can be processed unless this slip is signed. Under the Dat Protection Act, the Charity requires the HV (NHS employee) to have written permission from the client to hand on their details to the Charity (non NHS). If white goods are requested, the Charity also needs permission to hand on the client's contact details (but no social background information) to the Credit Union. If white goods are not needed, the Credit Union is not involved, and no information about the client is passed on.

I will obtain the signature of the client as proof of consent of referral to The Broomhill Nursey Charity and, if necessary, the Credit Union .

I will send the printed slip with the client's signature to Alison Leslie, Summerfield House by internal mail.

I will collect a cheque made payable to Asda, from Christine Masson, or Alison Leslie at Summerfield House,  and deliver the cheque to the Client. Please remember to stress to your client that the voucher can only be used at the ASDA store at Bridge of Dee.
Signed Date  

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