Wellbeing Fund Application

The Honeypot Wellbeing Fund forms part of our wraparound service for young carers and children aged 5-12. An application for a grant of up to £250 may be made on behalf of a child by their family or by an appropriate professional working with the child and their family.

Following receipt, an application for a grant award will be presented to the next scheduled Wellbeing Fund Administration Board which meets on a monthly basis. The person who submitted the grant application form - ‘the Applicant’ - will be notified of the Board’s decision within 7 days of that meeting.

Before completing this form please carefully consider whether the application you are seeking to make meets our objectives and eligibility criteria for this fund. Please also ensure you have read and understood the terms and conditions. Submitting a grant application does not guarantee access to funds, please take care to manage expectations accordingly.

If you are unsure, please contact us and we will be happy to discuss.

Wellbeing Fund Application

Section 1: Applicant details

The person submitting this form is known as 'the Applicant'. Please complete the question below then proceed to the section specified alongside your response.

What is your relationship to the child on whose behalf you are submitting this application?

I am a Professional working with the child/family

I am the child's Parent/Guardian

Section 2: Details of the child

Only children currently registered for Honeypot services and aged between 5 and 12 (inclusive) may be considered for a grant.

How many registered Honeypot children in the household are intended to benefit from this grant application?

Child's name

Child's date of birth

Child's address

Section 3: Home situation

Who lives at home with the child?

Do any of the following family characteristics apply to this child? Tick all that apply

Section 4: Caring responsibilities

Is the child a young carer?

Yes

No

Section 5: Social Services and professional support

Is the child open to social care?

No

Yes (please provide Social Worker name, contact number and/or email address

Is the child on the Child Protection Register?

No

Yes (please give details)

Does the child have a CAF?

No

Yes

Unknown

Are other agencies engaged with the child?

No

Yes (please give agency type, nature of their engagement, contact name, contact number and/or email address

Section 6: Education

School name

School address

Section 7: Compatibility with fund eligibility criteria

There are a number of specific grounds on which a child may be considered eligible for a grant. Please identify the way(s) in which the child meets those eligibility criteria.

Which of the following eligibility criteria apply to the child? Tick all that apply

A) The child is eligible for Free School Meals

B) The child (via their school) is in receipt of the Pupil Premium

C) Household member is in receipt of Carer's Allowance

D) Household member is in receipt of Personal Independence Payment (PIP)

E) Household member is in receipt of Disability Living Allowance

F) Household member is in receipt of Employment and Support Allowance

G) A qualified professional working with the child is sponsoring this application

None of the above

Section 8: Purpose of the grant

Please describe the purpose for which funding is sought. What product or service requires funding? Please provide as much detail as possible.

What is the financial value (cost) of the requested product or service? If a precise value is not known, please estimate.

What is the intended benefit of the product or service to the child? Tick all that apply

Overcome social isolation/loneliness

Address anxiety/low mood/depression

Facilitate access to education (e.g. travel, uniform, school trip)

Improve educational attainment (e.g. additional academic support/resources)

Mitigate impact of caring responsibilities

Access respite services

Enable childhood pursuits (e.g. access to leisure, fun, entertainment)

Develop a skill, hobby or interest (e.g. purchase of a musical instrument)

Obtain household necessities (e.g. white goods)

Tell us if there is anything else you would like to say in support of this Wellbeing Grant application?

Section 9: Agreement

In submitting this grant application form you assert that all information contained herein is a true and accurate representation and that you have read and understood the Fund's terms & conditions.

If you ARE the parent/guardian of the child on whose behalf this application is made, you confirm your consent to Honeypot sharing the application with other relevant parties as identified in this form for the purpose of validation of entitlement.

If you ARE NOT the parent/guardian of the child on whose behalf this application is made, you assert that you are submitting this application with the parent/guardian's knowledge and explicit permission, and further that they explicitly consent to Honeypot sharing the application with other relevant parties as identified in this form for the purpose of validation of entitlement.

I confirm my understanding of, and agreement with, the above statement.