GroceryAid Financial Grant Application

GroceryAid Financial Grant Application

If you require any assistance completing this form, please contact our Head Office on 01252 875 925. Select (Option 1) for Welfare, contactable during office hours.
1. Personal Details
Applicant Name *

Prefix First Name Last Name
Date of Birth *

Day Month Year
Marital Status *

Your Partner/Spouse
Full Name *

Prefix First Name Last Name
Date of Birth *

Day Month Year

Household Information
Do you receive Child Benefit for any children who live with you? *
How many dependants are you receiving Child Benefit for? *
Name of 1st Dependant

First Name Last Name
Date of Birth

Day Month Year
Date
Name of 2nd Dependant

First Name Last Name
Date of Birth

Day Month Year
Date
Name of 3rd Dependant

First Name Last Name
Date of Birth

Day Month Year
Date
Name of 4th Dependant

First Name Last Name
Date of Birth

Day Month Year
Date
Name of 5th Dependant

First Name Last Name
Date of Birth

Day Month Year
Date
Name of 6th Dependant

First Name Last Name
Date of Birth

Day Month Year
Date
What is your current situation? *
What is your Partner/Spouse's current situation? *
Address

Address Line 1

Address Line 2

City County

Postal Code
Accommodation type *

Contact Information
Email *

Confirmation Email Please re-enter your email address.
Telephone Number
If you require any assistance completing this form, please contact our Head Office on 01252 875 925. Select (Option 1) for Welfare, contactable during office hours.

2. Employment

Employment Information
NI Number *
Please enter the details of all grocery employment, include previous and current.

If you are unsure on exact dates please select by month.

To add multiple employers please use the 'Add Further Grocery Employment' button.

Employment Evidence
Please upload your employment evidence below, you must provide evidence of at least one full year's grocery service if working in grocery now or five full years if no longer working in grocery.

If you are unsure what evidence to provide please go back to the 'How to Apply' page on our website for further information or see below for acceptable forms of employment evidence.

Examples:
- Letter/Email from your employer on letterhead or from a company email address.
- Official documents such as P60's for each year of employment or multiple payslips.
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Partner/Spouse Grocery Employment
Has your Partner/Spouse worked in the grocery industry?
If your partner is currently working within the grocery industry and can evidence a minimum of one year's service or more they may be eligible for support in their own right. We would encourage that they also submit an application in their name.
If your partner has previously worked within the grocery industry and can evidence a minimum of five year's service or more they may be eligible for support in their own right. We would encourage that they also submit an application in their name.
If you require any assistance completing this form, please contact our Head Office on 01252 875 925. Select (Option 1) for Welfare, contactable during office hours.

3. Financial

Financial Information
GroceryAid requires evidence of all household income, expenditure and savings in order to progress your application. Please read this section carefully and decide how you would like to provide your financial evidence.
Do you have access to online banking? *
GroceryAid has partnered with Consents.Online to offer you a secure and easy way to provide your financial information digitally.

How does it work?
- Simply give Consents.Online permission to access your account information via a secure link emailed to you.
- GroceryAid will then be provided with one-time access to view your last 3 months bank statements to check you meet our financial criteria.
You will be asked to provide:
- Details for all bank accounts held (account name, sort code, account balance).
- Your name, address, telephone numbers and email address as held by your bank/card issuer.
Please note, some banks are not supported by this API service. If your banking provider is Co-op or Metro you will not be able to continue and will be asked to provide your financial data in an alternative way.

This is the quickest way for your GroceryAid Application to be assessed, however, you can choose to upload your bank statements in the 'Financial Evidence' section below if you prefer.

Consents.Online Agreement
Please select an option for how you would like to proceed. *

I agree to provide required information through Consents.Online. I do not agree and would like to upload or send my financial evidence by email. I am unable to continue as I bank with Co-op or Metro.
Thank you for agreeing to provide your financial evidence via Consents.Online. Upon completion of the application you will be redirected to a webpage confirming the link you need to follow to complete this process.

We suggest you complete this on your mobile device as this is the easiest way.

If you need to upload any additional financial evidence to support your application that you cannot provide via Consents.Online please do so in the upload section below.

For example, if you receive Universal Credit or a State Pension, please upload your breakdown statement to verify your income and expenditure. We will accept a screenshot of your breakdown statement.
Confirm the email address you will use to register for Consents.Online.
example@example.com
As you confirmed you are 'Living with a Partner/Spouse' you will be required to provide their registered email address to continue. By giving their email address you agree for GroceryAid to send a link to them for their banking information to be shared through Consents.Online.
Your Partner's email address
example@example.com
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Financial Evidence
You will need to provide the last three months bank/building society statements evidencing all household income and any rent/mortgage costs, and all household savings, this may mean you have to provide several bank account statements. If you do not provide bank statements evidencing all household income and housing costs, then your application will be rejected.

Bank statements can usually be downloaded as a PDF from your online banking. These can be saved to your device and then uploaded to our application form. We will not accept incomplete screenshots or excel downloads.

If you receive Universal Credit or a State Pension, please upload your breakdown statement to verify your income and expenditure. We will accept a screenshot of your breakdown statement.
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Household Employment Income
If any of the following fields are not applicable for your income and expenditure then please leave blank to continue.
Employment Income
Partner's Employment Income

Household Pension Income
Income from State Pension
Are you in receipt of Pension Credit Guarantee?
If yes, please complete the below for your Pension Credit Guarantee. *
Partners Income from State Pension
Do you receive any income from an Occupational Pension?
Partner/Spouse Occupational Pension Income

Household Benefit Income
You might not realise you're getting a benefit - check our list below and select each one that you're receiving. Then enter the amount you receive for it and the frequency of this payment.

If you add a benefit by mistake, select remove.
Do you receive any benefits?
Does your Partner/Spouse receive any benefits?

Additional Income/Investments
Do you receive any Child Maintenance?
Do you receive any income from a lodger or anyone else living with you?
Do you receive any income from investments? This is any income you get from renting out a property, dividends or interest on savings.
Investment Income
Is there any additional income you would like to declare?

Household Expenditure
GroceryAid uses figures from the Joseph Rowntree Foundation Minimum Income Standards to calculate living costs so we only need to collect the below expenditure.
Rent or mortgage
Council Tax
Child Support/Maintenance payments you make

Household Savings
Total in all Bank or Building Society Accounts
Total in Premium Bonds, ISA's or Shares
I confirm this is a true representation of my total household savings which are less than £6,000. *

I Agree
If you require any assistance completing this form, please contact our Head Office on 01252 875 925. Select (Option 1) for Welfare, contactable during office hours.

4. Reason for Applying

Reason for Applying
Please select the category/categories which best explain your reason for application. *
Please tell us the reason for your application, what happened and how you would like GroceryAid to help. If relevant please include information about your current state of health and that of your household, any disability or illness. *
Debt: If you are worried about a particular debt or are applying for debt fees please tell us about this and upload any arrears statements or a debt advice report if you have already received debt advice. GroceryAid can offer you impartial debt and budgeting advice with StepChange through our free Helpline on 08088 021 122.

Additional Evidence
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If you require any assistance completing this form, please contact our Head Office on 01252 875 925. Select (Option 1) for Welfare, contactable during office hours.

5. Declarations and Submit
How did you hear about us? *
Has any other charity been approached for assistance? *
Which charity?
Have you previously applied to GroceryAid for a Financial Grant ? *

Terms & Conditions
I confirm that everyone whose details are included on this form have read, understood and agreed to the above declarations. *

I Agree
If you require any assistance completing this form, please contact our Head Office on 01252 875 925. Select (Option 1) for Welfare, contactable during office hours.
Should be Empty:

GroceryAid Financial Grant Application

1. Personal Details

2. Employment

3. Financial

4. Reason for Applying

5. Declarations and Submit