Neighbourhood Renewal Community Chest and Community Learning Chest

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					                WAKEFIELD FLOOD RELIEF RECOVERY FUND
    Small grants application form to relieve hardship and distress in the aftermath of the floods

Thanks to the generous contributions from local individuals, the British Red Cross and the City of
Wakefield Metropolitan District Council, the Community Foundation for Wakefield District has
approximately £60,000 to distribute in grants. These will be given to individuals and community-based
organisations who have been hardest hit by the floods which occurred on 25 June 2007. This form is for
individuals or families. If you are a community group, please ask for a separate form and criteria.

In order to process your application, you need to:
 Answer all the questions on the form
 Enclose two original documents with your name and address on them such as a driving licence,
    electricity bill or recent bank statement.
 Sign the form and return all documents to the address at the bottom of the page

HOW WE WILL JUDGE WHETHER WE CAN GIVE YOU A GRANT

The main criteria is that you must have suffered material loss as a result of the flooding on 25th June 2007
either to your property, equipment, furniture & furnishings in habitable areas of your home i.e. kitchen,
lounge, bedroom.

We will check your details against a defined list of properties that have been flooded in Wakefield and
may ask for further proof of damage if your property details are not on this list.

We can particularly provide support to help with the following:

   Cleaning or replacement of essential items       Replacement of specialist equipment which assists
    i.e. basic furniture, beds, fridge, washing       in the management of a health condition or
    machine, cooker, kettle etc                       disability
   Cleaning or replacement of floor coverings,      Additional heating or cleaning costs spent on drying
    bedding & soft furnishings                        out flood damage


We can consider other requests not mentioned on this list. However each request will be looked at on its
own merits and you will need to demonstrate genuine need. Priority will be given to those still remaining
out of their homes at the date of application.

Please note that there is a limited amount of funding available to distribute for the Wakefield Flood Relief
Recovery Fund. This small grants scheme is not intended to cover all your losses, but to relieve
immediate or continuing hardship. This is the second round of grants and as such priority will go to:
 those who have not yet claimed.
 those that have already received a grant, but are still out of their homes (eligible to apply for a second
   top-up grant dependent upon how many applications are received and how much of the fund is left to
   distribute).

Only one Phase 2 application will be accepted per household so please include all relevant information in
your application.

                              For further information please contact:
 Wakefield Flood Relief, c/o The Community Foundation for Wakefield District, Town Hall, Wood
 St, Wakefield WF1 2HQ or email floods@communityfoundationwakefield.co.uk or ring (01924)
                                               306758
                    WAKEFIELD FLOOD RELIEF RECOVERY FUND
             SMALL GRANT APPLICATION FOR INDIVIDUALS AND FAMILIES


Please complete the form in TYPE or BLACK PEN, making sure that any hand-writing is easy
to read as the form will be photocopied. Please ensure you have read the guidelines before
completing the form.


Applicant’s Details
Title - Mr/Mrs/Ms   First Name                            Surname / Family Name

……………………... ……………………..……..………… …………………………..………………
                               ……..
Address of affected property
Address




Postcode

How can we contact you?
The address above 

Another address:



Phone              Day                                  Mobile

Email

Do you own your home? Yes / No
When did you move in to the Property? (Month/Year)

If you rent your home / are a tenant, please supply the details of your landlord / housing
association i.e. name and phone number. Applications from landlords are not allowable.




What kind of property is it i.e. flat / terraced house / semi-detached house etc.
……………………………..
If we are able to make you a grant, who should we make the cheque payable to?

………………………………………………………………………………………………………………
Describe the impact of the flood on your home (e.g. house flooded, loss of electricity,
items destroyed)




So we can assess the benefit of the use of the grant, what do you intend to use the money for?

DETAILS                                                              AMOUNT
                                                                     £



                                                                     £



                                                                     £



                                                                     £



                                                              Total £

Did you have to move out of your home because of the        Yes No 
flooding?
If you did have to move out of your home because of the flooding please give the dates that you
moved out and the date that you moved back in or your expected return date:
Moved out:

Moved back in (if applicable):

Expected return date (if applicable):


How did you hear about the Wakefield Flood Relief Recovery Fund (Yorkshire Post, Yorkshire
Evening Post, other newspaper, radio, television, Council website etc)
Declaration

   1. I certify that the all the information contained in this application is correct.

   2. If the information in the application changes in any way I will inform the Community
      Foundation for Wakefield District

   3. I understand that the Community Foundation for Wakefield District reserves the right to
      reclaim any money which has been paid as the result of fraudulent or misleading claims

   4. I agree to my personal details being kept by the Community Foundation for Wakefield
      District for the purposes of administering this application and any grant made.

   5. I give permission for my details to be checked against Council-held information on
      previous flood grant applications and/or Council Tax systems

   6. I give permission for the Community Foundation for Wakefield District to share the
      information contained in this application with the Red Cross so that they can approach me
      to build reports on how the grants have helped (if you do not want to be approached by
      the Red Cross please put a cross through this box      )

Signed                                                                      Date




REMEMBER

Please check that you have
    answered all the questions
    signed the form
    included two originals of a document with your name and address on it such as a driving
      licence, utility bill or recent bank statement.

                             For further information please contact:
Wakefield Flood Relief, c/o The Community Foundation for Wakefield District, Town Hall, Wood
St, Wakefield WF1 2HQ or email floods@communityfoundationwakefield.co.uk or ring (01924)
                                              306758

For office use only
App No:                                             Date received:
F:                                                  ID:
Out of home:                                        Amount to be paid:
Date cheque issued:                                 Cheque No:
P1 Y/N                                              P2    Y/N

				
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posted:11/23/2011
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