Holiday Bursary Form

    If your TOTAL HOUSEHOLD annual income is £35,000 or less, you may be eligible to apply for a holiday bursary and/or transport bursary.


    Please write in the weekly/monthly amount you receive for each benefit/source of income. IF NO BENEFIT IS RECEIVED, PLEASE PUT IN A ZERO

    Complete and return the application form together with evidence (photocopies and photographs are accepted) of your benefits and other income. Once this form has been completed you will eligible for a bursary subject to documentary evidence.

    Means Tested Benefits:

    Income Support
    £
    Employment Support Allowance
    £
    Working Tax Credits
    £
    Child Tax Credits
    £
    Income-based Jobseeker's Allowance
    £
    Incapacity Benefit
    £
    Pension Credit
    £
    Universal Credit
    £
    Do you receive Housing Benefit?
    If yes, please state amount:
    £
    If yes, is it paid directly to your landlord?

    Non-Means Tested Benefits:

    Full or Part Time Work
    £
    Disability Living Allowance/PIP
    £
    Child Benefit
    £
    Carer’s Allowance
    £
    State Pension
    £
    Other Income/benefits
    £

    3H - Helping Hands for Holidays