Application for General Support

Apply for a Grant

Name of Applicant

Name of Spouse / Partner

Address

Telephone number

Email address

Date of Birth

Marital status

Number of Children and ages

Do you own your own home?

Employment history within the Jewellery Industry -last 3 with names and dates. Give as much detail as you can to support your application.

Do you own your own business?

Do you have a website / use social media?

Do you belong to any professional organisations within the jewellery industry? - please list.

Do you receive help from family members?

Have you applied to or do you receive support from any other charities?

Do you have a physical or mental illness? Please give as much detail as you can to support your application.

Reason for Application

How did you hear of us?

Your Income

Partners Income

State / Private Pensions - please list

Housing Benefit

All other benefits – please list

TOTAL income =

Money in Current Accounts – please list

Money in Savings Accounts – please list

Rent (before Housing Benefit)

Mortgage payment

Council Tax

Water Rates

Gas & Electricity

Telephone / Broadband / TV subscriptions

TV Licence

Car Loan

Car – Fuel /Insurance/Tax

Insurance – Life, building /contents/endowment

HP or other debts – List all, including amounts outstanding

Housekeeping / Food

Business expenses still being paid – please list

Anything else – please list

TOTAL Expenditure =

TOTAL in Current Accounts at present

TOTAL Savings in all sources

Applicants are advised that the function of the Silversmiths & Jewellers Charity is not to relieve the Department of Social Security, the Department of Work and Pensions or Local Authorities from any responsibility they may have to the applicant.

To confirm that you are who you say you are we may ask you for a professional reference. We also reserve the right to ask for bank and benefit statements.

Apply for a Grant

If you would like to attend any of our fundraising events above, please email Julie Griffin julie@thesjcharity.co.uk