Counselling4Carers Form

Please fill in all the fields marked *

  • Agency Details

  • Carers details

  • DD slash MM slash YYYY
  • Information about the grant you are applying for

  • The trustees regret we are unable to reimburse costs already paid or anything that has been booked, contracted for or reserved prior to our agreement to fund/part-fund the cost. Many of the grants we award are under £300 and we may ask a carer to contribute towards the cost of an item.

If you have any difficulties in completing this form or would like to discuss your application, please telephone 01202 698325 or email