Request for help

If you receive a benefit

If you receive a means-tested benefit, do not use this form. Complete our Local Discretionary Social Fund form instead.

About this form

Use this form to get help with:

  • accessing food, groceries, and essential supplies
  • getting information and advice about wellbeing support services
  • getting information and advice to help pay for gas and electricity
  • other support you may need in an emergency 

To apply for help for yourself you need to:

  • tell us your age or date of birth
  • give us your contact details including:
    • email and phone number
    • address

To apply for help for someone else you need to:

  • tell us who you are trying to get help for
  • tell us their age or date of birth
  • give us contact details for the person you want to get help for including:
    • email and phone number
    • address

If you need help to fill in this form, you can:

We process, analyse and use your data in a range of ways to better understand what our customers need and to improve the way in which the council delivers your services.

Find more information about how we use your data in our privacy and data notice.