Lennox Children's Cancer Fund
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    Care Grant Application

    Your application can be sent at any time.
    Every application will be given careful consideration and you should receive a response within six weeks of your application being received. Please ensure that you complete all sections of this form as fully as possible, as we are unable to consider incomplete applications.
    If your application is urgent, please let us know.

    Whether your application is successful or unsuccessful, you are welcome to apply for another care grant again at any time. However, if you have previously received a care grant or respite break from us, priority will be given to new applicants.  

    Who Is Making This Application?

    If you are not the parent or main carer of the child that this application is for, please give your contact information.

    About The Child

    DD/MM/YYYY

    Diagnosis and Treatment

    Treatment Contacts

    Parents and Siblings

    Main parent/carer:
    ​
    This will be our main contact.
    Other Parent/Carer:
    Siblings:
    If there are no siblings, please write 'none'.

    The Grant

    Other Information

    Data Protection

    ​Occasionally Lennox Children’s Cancer Fund is approached by the media to talk about its work. This will raise Lennox Children’s Cancer Fund’s profile, which could help us assist more families. Your answer will not affect the outcome of your application.
    In order for us to continue supporting families through our Care Grants project, it is important that we show the public how their money helps. We may choose to share your family’s story, photos and videos. Please be assured that we will never pass your contact details to a third party and we will never share surnames.
    If you would like to send us photos or videos to go with your story, please email them to us at caregrants@lennoxccf.org.uk, or upload them here.
    Max file size: 20MB

    Payment

    If a care grant is awarded, it is likely to be paid to you via direct bank transfer or cheque. To speed up the payment process, please provide your bank account details. If you would prefer not to give your bank details online, please call us to give your account information by telephone.
    The name shown on your bank statements
    8 digits
    6 digits

    Declaration

    Our telephone number is 01708 734366. Please save this in your phone so that you know it's us when we call you.
    Please press the submit button once and wait for a confirmation message to appear.
    This may take a few minutes.
Submit