Young Carer Wellbeing Fund Form - Caregivers Connected Gateshead

Before applying, please ensure that you have read through our Carer Wellbeing Fund guidelines before making your application.

Young Carer Wellbeing Fund Application Form

You can apply every 12 months to the Young Carer Wellbeing Fund for something that promotes your wellbeing (physical, mental or emotional health). We can only accept one application per family. If the grant is successful, we shall transfer the funds directly into your bank account. This could take up to 30 days once approved to reach your bank account. If you receive a grant, you will be expected to complete a short evaluation 3 months later about how it has improved your life.

Young Carer's Name(Required)

First Last

Young Carer's Date of Birth(Required)

Young Carer's Email Address(Required)

Address(Required)

Address Post Code

Parent/Guardian's Name(Required)

First Last

Parent/Guardian's Phone(Required)

Parent/Guardian's Email Address

Cared For Person's Name(Required)

Cared For Person's Medical Condition(Required)

What care does the young carer provide?(Required)

What are you applying for?(Required)

Please include the make, model, colour, size, shop, etc.

Please provide additional details such as make, model, colour, size, etc.(Required)

What store or website is this available from?(Required)

Please include the link from the website into the application so that we know exactly what it is you’d like to purchase.

What is the cost?(Required)

How will you pay the difference if the full price is not granted?(Required)

How will having this item benefit you as a young carer?(Required)