Information for Referrers

Our Direct Grants programme is here to help individuals and families in Elmbridge who are facing financial difficulty. To apply for a grant, applicants must have a referral from a local organisation.

How to make an referral

Step 1: Check the grant request meets our funding criteria in our Grant Guidelines.

Step 2: Complete the referral form below

Step 3: Once we have received and processed the referral, we will ask the applicant for their supporting documents (such as bank statements).

Note, if you already hold a Walton Charity Delegated Fund or a Walton Charity Opportunities Fund, it may be easier to support the applicant directly through your fund. If you’re not sure if the request meets the purpose of your fund, contact Amina to discuss on 07935 218699.

Referral Form

SECTION 1 - Referring organisation's details
Referrer's name
SECTION 2 - Applicant's details
Applicant's name
Age
Employment status
SECTION 3 - Please tell us who lives with the applicant
SECTION 4 - Please tell us about the applicant's health
Health & disability
Are there any concerns regarding lone working?
SECTION 5 - Support required (please select the relevant section)
Household funding
Transport funding
Funding for children & young people (please note school uniform is only available through Opportunity or Delegated Funds)
Vocational funding
£
SECTION 6 - Statement & other support
Does the applicant have caring responsibilities? (please select all that apply)
SECTION 7 - Please tell us about the applicant's finances
£
£
£
By signing this form and seeking grant support from Walton Charity, you agree for us to process the applicant's legitimate, personal information and you are acknowledging our privacy statement and sharing protocol which can be found at www.waltoncharity.org.uk/privacy
Date

Have a question about the form or making a referral? Contact Amina on 07935 218699, we’re here to help!

By signing this form you are acknowledging our Privacy Statement and sharing protocol which can be found at: www.watoncharity.org.uk/privacy