Online Grant Enquiry Form – Citizens Advice Richmond

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KEEPING RECORDS ABOUT YOUR CASE

We need to record information about you to help with your enquiry. We have a legitimate interest to do this. Please let us know if you’d like more information about how we’ll use your data.
When we record and use your personal information we:
● only access it when we have a good reason
● only share what is necessary and relevant
● don’t sell it to commercial organisations

Your Title

Mr/Mrs/Miss/Ms etc.

Your FIRST Name *

Your SURNAME *

Home Postcode *

Home Address

Date of Birth (DD/MM/YYYY) *

Gender

Male

Female

Unknown/declined to reply

Please tick the consent box below, so that Citizens Advice Richmond can share information with the Richmond Council or Richmond AID on your behalf.

Citizens Advice Richmond and Richmond AID are administering the Household Support Fund grant on behalf of the London Borough of Richmond upon Thames (LBRuT) Council.

I give my consent to share my name, address and national insurance number with Richmond (LBRuT) council.

I give my consent to Citizens Advice Richmond to share my name and postcode with Richmond AID to avoid duplication in grant awards.

Data protection and sharing

Yes I consent to sharing

I do not consent to sharing

If you are human, leave this field blank.