Request Request Assistance Your Name Your Email Application for Assistance Please detail the Reason for the application and the type of assistance required, ie. relief from poverty; sickness; helplessness or distress? Document that may be needed to support application. To support your application we may require proof that assistance will support the quality of life of a child or adult. Please indicate what evidence you may be able to provide: Doctors/Specialists referrals and medical information Workplace Termination letter Copies of rent or mortgage /other loan payments Bank statements Utility Bills Proof of income / expenses Evidence of any other support being received eg. from other charities Request Assistance
