Welfare Fund Application Survey

Section 1

1.Full name

2.Email address

3.Phone number

4.Preferred contact method

Phone

Section 2

5.What event/activity would you like help paying for?

6.What is the date of the event/activity?

7.What is the total cost of the event/activity?

8.How much financial assistance are you requesting?

Full subsidy- I need help with the full cost

Partial subsidy- I am able to contribute towards the cost

9.If partial subsidy, how much are you able to contribute?

Section 3

10.Please briefly tell us why you need financial assistance to participate in this event or activity.

You do not need to provide detailed personal financial information. We simply want to understand the barrier you are facing so that we can consider your request fairly.

11.Is there anything else you would like us to consider when assessing your application?

This is optional.

Section 5

12.Declaration and privacy
Please read the statements below before submitting your application.

I confirm that the information I have provided is accurate to the best of my knowledge.

I understand that applications are assessed individually and that financial assistance is subject to eligibility, approval and the funds available.

I understand that submitting an application does not guarantee that funding will be awarded.

I understand that Marauders Men’s Health will use the information I provide to assess and administer my application, maintain appropriate financial records and meet relevant legal and governance obligations.

I understand that my application will be treated confidentially and that information will only be shared with authorised people who need it to administer, assess, approve, audit or oversee the fund, or where disclosure is otherwise legally required.

13.Signature (name)

What happens next?
Once we receive your application:

We will acknowledge receipt, normally within five working days.
We will assess your request confidentially and may contact you if we need clarification.
We will normally let you know the outcome within ten working days of receiving a complete application, or sooner if the event deadline requires it.
If your application is approved, we will confirm the amount of support and explain how the subsidy will be arranged.
If your application is unsuccessful and you believe relevant information has been overlooked or the process has not been followed correctly, you can request a review.

Thank you for completing this form. We want every Marauder to feel welcome, included and able to participate.