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

Diagnosis and Treatment

Treatment Contacts

Parents and Siblings

Main parent/carer:
This will be our main contact.

Other Parent/Carer:

Please give the full name, gender and date of birth of siblings, and other children living at the same address. *

The Grant

All initial grant requests are for £250. Please explain how this grant would be used, including any deadlines, and explain how it would benefit the child *

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.

Would your family be willing to represent the charity either in a photograph, on radio, on TV or by talking to a journalist? *

Yes No

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.

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.

Declaration

By submitting this application I confirm that the information I have given is correct and true to the best of my knowledge *

Yes