Shadwell Responds Fund Application
Please complete the questions below for the main applicant.
1. Are you filling this out on behalf of someone else? *
2. Name: *
3. Your telephone & email details *
4. Who would you like us to contact if the applicant is successful
All questions below refer to the applicant
5. Applicant Name *
6. Applicant Address *
7. Applicant Postcode *
Age *
Please provide number and age of any children resident at this address. Please also provide details of any other dependents, this includes full-time students. *
Please provide the number and age range of any other working-age adults resident with the applicant. *
Please chose an answer from below that best describes your families source(s) of income 2019/2020 before March. It doesn't matter if it's one person with all sources of income or multiple people each with a different source. *
If not receiving government/council support of any kind please estimate the families income for April 2019 to April 2020. If they are receiving government support then this question should be left blank.
Please detail the applicants connection with Shadwell. This could be that they are resident (or were until recently) in the ward, work in the ward, or have a connection with one or more of the below institutions. Please note that there is some flexibility on geography but that primarily this fund is for people with a strong connection to Shadwell. Institutions: St George's in the East, St Paul's Shadwell, Daral Ummah Mosque, St Mary's Cable street. *
Please provide details on how the applicant(s) have been affected financially by the pandemic. *
Please provide details, if any, of successful applications to other funds. This does not exclude the applicant.
Please provide more details on what the applicant(s) needs the grant for and the desire value of the grant. A shopping list of items you would spend the money on (e.g. Nappies, sanitaries items) and if it’s for a bill then please provide the bill value (e.g. phone £11, prepayment meter £10). Most grants are expected to be in the range of £30-50 total. If there is any supporting evidence like a bill please email it to Shadwellcitizens@gmail.com *
Please tick the box below if the applicant consents to have St George in the East, [St Pauls Shadwell, St Mary's Cable Street & Darul Ummah Mosque] to process and store their data for the award of this grant only. This data will be deleted within one year of application. *
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