welfare & benevolent funds by anrLZ6T

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									                  British Airways Welfare and Benevolent Fund
                                                                         Strictly Confidential
                              APPLICATION FOR GRANT


British Airways Staff Member                                 Staff No: _____________

Full Name:______________________________________               Dob : _______________

Address: ______________________________________________________________

         ________________________________________ Tel No: _______________

Date of Joining: ___________________            Date of Retirement: ________________




Applicant’s Details (if not the staff member)
                                                Relationship to
Full Name: _______________________ DOB ________ applicant ___________________


Immediate Family
Name &
Relationship: ________________________ Age _____ Location: _________________

             ________________________             _____             ________________

Family Support (Please describe any help given by family)
_____________________________________________________________________
_____________________________________________________________________

_____________________________________________________________________

Relative urgency : Meetings are bi-monthly and the normal procedure is to add new
applications to the agenda for the next meeting. If your application requires more urgent
consideration please justify plus indicate the nature of the urgency / any impending deadlines
__________________________________________________________________________

__________________________________________________________________________




Nature of Problem and Assistance Sought (please give full details - if more space
is require please attach additional free-format sheets as required )
_____________________________________________________________________

__________________________________________________________________
                  British Airways Welfare and Benevolent Fund

INCOME (Please tick boxes & enter amounts per annum for applicant & spouse)

INCOME                     TICK     AMOUNT                          NOTES
                                      £
BA Pension
State Pension
Other Pension(s)
Income from
employment
Annuities/Dividends
Social Security
Benefits
Housing Benefit
Community Charge
Benefit
Property Rentals
Other Income
Sources (Specify)
Total Income p.a.

EXPENDITURE (Please enter amounts per annum per household)

                                   AMOUNT                         NOTES
                                     £
Mortgage Payments                             Amount outstanding: £
                                              Term:     years     Expires:     /     /   (date)
Rent                                          * show amount paid after any benefits deducted
Residential home fees
Home help
Council Tax                                   * show amount paid after any benefits deducted
Light, Heat and Fuel
Water
Telephone (home/mobile)
Car (incl tax,ins,fuel,maintnce)
TV (Rental and/or licence)
Insurance (life, home, health )
Clothing
Hire Purchase Payments / loans                * show total of instalments paid annually
Card Interest Payments                        * show interest only - annual total)
Food / cleaning materials etc
Incidentals (pharmacy,
newspapers etc)
Other

Total Expenditure p.a.

If total income exceeds total expenditure please explain how the surplus income is used

………………………………………………………………………………………………….
                British Airways Welfare and Benevolent Fund
Credit       (Please enter amounts per annum per household)

                                 AMOUNT                            NOTES
                                   £
Unpaid debts/bills
Owed on Credit Cards
Loans/hp – amount outstanding                 Total amount incl. Interest, less payments to date
Overdraft

Total Expenditure p.a.

                                ADDITIONAL INFORMATION


CAPITAL                  TICK     AMOUNT                           NOTES
                                    £
Value of residence                              (if owned)
Other Properties
(UK &/or Overseas)
Bank Account
Building Society
Other Savings
Investments
Other (pls specify)



OTHER SOURCES            TICK     AMOUNT                         RESPONSE
OF ASSISTANCE
CONTACTED
Other Employers
BA25 Club
Social Services
British Legion
BALPA
Services charities
SSAFA/RAFA etc
ACT Foundation
CAB / CCCS


PROPERTY (ring as appropriate)

TYPE:                 House, Bungalow, Apartment, Flat, Mobile Home,
                      Sheltered Housing, Residential Home, Nursing Home

TENURE:               Freehold, Leasehold, Council House or Private Rental



                British Airways Welfare and Benevolent Fund
                                      CERTIFICATE
                              (To be read out to the Applicant)

I certify that to the best of my knowledge the information provided on pages 1,2 and 3 is
correct and that I understand that any incorrect statement may be regarded as an endeavour to
obtain help under false pretences. I agree that my service details may be disclosed by British
Airways to the Trustees and that the DSS or any other appropriate agency may be consulted in
confidence on matters relevant to this application. Where appropriate I agree to information
relating to this application being shared with the 25 Year Club Benevolent Trust.


Date:                               Signature of Applicant:




PENSIONER CONTACT REPORT




Date:                        Signature:                            Area:




ADVICE GIVEN TO APPLICANT BY CONTACT

								
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