Urgent Anchor Resident Support Fund application form

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Urgent Anchor Resident Support Fund application form

Anchor Resident Support Fund

Application form for Food, Energy and Wellbeing Essentials

If you would like to apply for our Anchor Resident Support Fund and require urgent funding, please complete the form below.

Vouchers are available up to a maximum of £300 per household for food and £200 per household for energy and wellbeing essentials in a 12-month period. Warm winter clothing vouchers are available for up to £60 per household. We may ask for proof of your available savings before issuing your voucher.

We aim to respond to your request within three business days.

Application Form

Please tell us, are you:

An Anchor resident

Local manager

Customer services colleague

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Your name (if not an Anchor resident):

Title

First

Last

Resident's name:

Title

First

Last

Please select resident's ethnicity:

We are collecting this information to ensure equal and fair access to our resident support fund and better help us serve residents in the future.

Asian or Asian British

Black, Black British, Caribbean or African

Mixed or multiple ethnic groups

White

Other ethnic group

Resident's address:

Address

Address 2

City/Town

Post Code

Contact details

Please note - to issue energy vouchers we need both an email address and a mobile number. If you are unable to supply these for the resident, it may take longer for your voucher to be issued.

Preferred contact number for resident:

(please note, we may contact you regarding your vouchers)

Email address for resident or Location Manager:

Is the person you are referring aware of this referral, and have you gained their consent?

Yes

Additional information

To help us send you information that you might find useful, please let us know the following:

Do you currently receive any benefits?

Yes

Please let us know which benefits you currently receive:

Please tell us how much money you currently have in available savings*

*savings are defined as immediately available in funds in either current accounts, savings accounts or cash, which are not already due to be spent on a priority expenditure for example: rent or a utility bill

Do you have a disability or long-term health condition?

Yes

Does anybody else live in the property?

Yes

I confirm that all financial and circumstantial information provided is true and accurate to the best of my knowledge.