Application for support for NRPF
*(No Recourse Public Funds) Africans and Black struggling due to COVID19
*Floating Counselling is offering support with FOOD/ TOILETRIES / RENT / COUNSELLING

*Ready to apply? It’s easy! Simply fill out this form and Floating Counselling will be in touch.
Email address *
Does the person in need have a LINK to: Croydon, Lambeth or Southwark borough? (Live, Work, Education, Place of Worship) *
Does the person in need have a LINK to: Croydon, Lambeth or Southwark borough? (Live, Work, Education, Place of Worship) *
Please state which Borough and what LINK
Q1: Details of person referring? (Professional in the community) Name, email, mobile number, Company, Job title, and confirmation of proof you know the person meets our criteria of NRPF and African and Black?
Please fill in the rest of the form with Person in need's details
First Name *
Last Name *
Q2: Which of the following categories best describes you? *
Q3: If you ticked Black other, what is the other *
Q4: DOB (Date Of Birth) *
MM
/
DD
/
YYYY
Q5: Gender *
Q6: Mobile Number (we will be supporting via WhatsApp)
Q7: What's the number one thing you want to get out of Floating Counselling Supporting you?
Q8: If you need support for rent, how much do you owe (if anything) and what is your monthly rent? *
Q9: Admin plans to gather feedback via a 30min call at the end of our support period. Do you agree to attend? *
Submit
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