Apply for Funding

Data Consent

By completing and submitting the application form below the applicants give Margate & Dr. Peete’s Charity permission to circulate the applicants personal information to the Charities Trustees.

Please note, Margate & Dr. Peete’s Charity will only use your personal data for the purposes you have authorised.

By completing and submitting the application form below the applicant declares they have read and accepted the terms of Margate & Dr. Peete’s Data Privacy Policy.

By completing and submitting the application form below the applicant declares and hereby authorises Margate & Dr. Peete’s Charity to use their personal data in such a way as to decide whether to successfully grant the application for assistance.

By completing and submitting the application form below the applicant authorises Margate & Dr. Peete’s Charity to use their name, e-mail address or telephone number to inform the applicant as to whether my application to Margate & Dr. Peete’s Charity has been successful.

View Data Protection Policy

Declaration.

By completing and submitting the application form below, the applicants declare that the answers given are, to the best of their knowledge, correct. In the event that the applicant’s circumstances should improve or change, they will notify the charity immediately.

Application for Funding Form

Please apply for assistance by completing the form below or alternatively, download and complete the instructional steps on PDF.

Download PDF Application Form

Details of Applicant (required)

First Name *

Last Name *

Address *

Email Address *

Telephone Number *

Date of Birth *

Marital Status *

Occupation *

Name of present/last employer *

How long have you lived in the former borough of Margate? *

Family Details

Partner's Name

First Name

Last Name

Partner's Date of Birth

Partner's Occupation

Name of Partner's present/last employer

Children's Name(s) and Date of Birth's

Other Dependent's Name(s) and Date of Birth's

Details of any chronic disease or disability of applicant or family member(s)

Have you applied for social fund loan? *

Yes

Name of Third Party who can provide support for your application

e.g. Councillor, Clergyman, Doctor etc.

First Name *

last Name *

Organisation Name of Third Party supporting application *

Phone Number of Third Party supporting application

Country *

Number *

Your net income from employment * Please show amount PER MONTH

Your Partner's net income from employment Please show amount PER MONTH

Your occupational pension * Please show amount PER MONTH

Your Partner's occupational pension Please show amount PER MONTH

Your state benefits: Retirement Pension * Please show amount PER MONTH

Your Partner's state benefits: Retirement Pension Please show amount PER MONTH

Your state benefits: Income Support * Please show amount PER MONTH

Your Partner's state benefits: Income Support Please show amount PER MONTH

Your state benefits: Family Credit * Please show amount PER MONTH

Your Partner's state benefits: Family Credit Please show amount PER MONTH

Your state benefits: Unemployment Benefit * Please show amount PER MONTH

Your Partner's state benefits: Unemployment Benefit Please show amount PER MONTH

Your state benefits: Incapacity Benefit (Sickness Benefit) * Please show amount PER MONTH

Your Partner's state benefits: Incapacity Benefit (Sickness Benefit) Please show amount PER MONTH

Your state benefits: Severe Disablement Allowance * Please show amount PER MONTH

Your Partner's state benefits: Severe Disablement Allowance Please show amount PER MONTH

Your state benefits: Attendance Allowance * Please show amount PER MONTH

Your Partner's state benefits: Attendance Allowance Please show amount PER MONTH

Your state benefits: Mobility Allowance * Please show amount PER MONTH

Your Partner's state benefits: Mobility Allowance Please show amount PER MONTH

Your state benefits: Child Benefit / One Person Allowance * Please show amount PER MONTH

Your Partner's state benefits: Child Benefit / One Person Allowance Please show amount PER MONTH

Your state benefits: Housing Benefit * Please show amount PER MONTH

Your Partner's state benefits: Housing Benefit Please show amount PER MONTH

Your Maintenance payments * Please show amount PER MONTH

Your Partner's Maintenance payments Please show amount PER MONTH

Have you any other income or does any member of your family assist you? *

Yes

If Yes, please give details Please show amount PER MONTH

Total Monthly Income * Please state yours and your partner's total monthly income

Have you had any money deposited in the post office, building society or bank? *

Yes

If Yes, please give details

Do you have any other investments? e.g. Investment Bonds, Shares etc. *

Yes

If Yes, please give details

Do you own your own home? *

Yes

If Yes, state the amount outstanding on your mortgage

Are there any arears? *

Yes

If Yes, state how much

What are your monthly repayments? *

What are your expenses per month of: Rent *

What are your expenses per month of: Council Tax *

What are your expenses per month of: Water Rates *

What are your expenses per month of: Gas *

What are your expenses per month of: Electricity *

What are your expenses per month of: House Insurance *

What are your expenses per month of: Other Insurance *

What are your expenses per month of: Telephone *

What are your expenses per month of: Food Bill *

What are your expenses per month of: TV Licence *

What are your expenses per month of: Credit Card Repayments *

What are your expenses per month of: Bank Loan Repayments * Please state original amount borrowed

Period of Bank Loan *

Other expenditure per month *

Total monthly expenditure *

Please give details of any item/project that you are asking to be funded by Dr Peete's Trustees. * This should include Costs etc.

Please note: All fields MUST be completed for your application to be considered at the next trustee meeting

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Margate & Dr Peete's Charity