Do you have any outstanding DEBTS, e.g. credit cards, rent or council tax arrears, water rates, gas/electricity/phone bills? Yes If yes, please give details here and attach copies of the demands for payment
Have you ever been made bankrupt or entered into an IVA
If YES please give details and dates
Have you ever been cautioned or convicted of a criminal offence or are there any criminal proceedings pending against you?
If you have answered YES to either question, please provide details below:
Have you asked the Trust (UUWT) for a grant before? No
If yes – when was this?
Have you applied anywhere else for help with this request?
If yes, who have you approached and what was their response?
STATE HERE WHAT YOU NEED, WHY YOU NEED IT, AND THE ESTIMATED COSTS INVOLVED
OFFICE USE ONLY (additional information from interviews, phone calls etc)
OFFICE USE ONLY (details of any previous grants made to this applicant)
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(UUWT) GRANT APPLICATION FORM – ©SP – 02/11 (v10)