Application for A Short Welfare Break - RAF Benevolent Fund

J. EMPLOYMENT RECORD Please give details of current and previous employment
Employer From To Type of Employment
K. CERTIFICATE (to be read out to the applicant)
H I declare that the information I have given on this form is correct to the best of my knowledge.
H I agree that the information supplied on this form may be shared with voluntary or charitable organisations and relevant statutory
agencies for the purpose of furthering my application for assistance.
H I agree that the information supplied on this form may be shared with the Ministry of Defence and its agencies, including
Service Personnel and Veterans Agency, for the purpose of verifying my service in the Armed Forces.
H I agree that information collected as part of the application process may be retained so that any future
applications may be speedily processed, and that data generated may be used for follow up assistance,
statistical and research purposes.
Signature
Date
D D M M Y Y
L. REPORT OF WELFARE OFFICER/HELPER AND RECOMMENDATION
This statement should give a description of the circumstances of the applicant, what the need is and the opinion of the Welfare
Officer/Helper. Please use an additional sheet, if necessary.
Each applicant has been advised to complete the pre-admission assessment form and requested to forward it to the home. Yes
Signature Mr/Mrs/Miss/Mrs/Other Name
Address
Postcode
0
Branch Telephone Date
D D M M Y Y
April 2012