You can review your answers to the form questions here. If you need to make any changes, please click Amend. It is important to check that all the financial fields have been entered correctly. Once you have made any amendments necessary, please Review again before Submitting. If you are happy with your application, click 'Submit' to send it to us. Once you have clicked the 'Submit' button you will not be able to make any further amendments to your application.

 

Please ensure that you quote your Online Application Ref if you email or post your documents to us.

If you do not receive a confirmation email from us within 12 hours of completing your application, please log back in using the same email address and password, as this probably means you have not completed your application and it has not been submitted.

 

(If you have come to this screen via the View all questions before registering link on the Welcome screen - the above will not apply until you register and complete the application.)

A1
*

Your Name (Title, Forename, Surname)

Please enter your full title if you are a serving/former member of the clergy eg: Canon, Reverend, Reverend Doctor etc.


         
A2
Your address
*Address1:      
  Address2:    
  Address3:    
  *Town:    
  *County:    
  *Postcode:    
  Country:    
A3
*Your e-mail address

Please insert the same email address here as the one you registered with. (This email address will be used to send you an acknowledgement and a copy of your application form once you have submitted it).
      
A4
*Telephone Number

        
A5
Mobile Telephone Number

        
A6
*National Insurance Number

      
A7
*Date of Birth

      
A8
*Marital status

      
A9
*Where did you hear about Clergy Support Trust?

      
B1
*It is always helpful for the trustees to understand the needs of our applicants. Please explain, in your own words, what difference a financial hardship gift from the charity would make to you. However, any information provided here will not affect the level of your gift.

(You can use a maximum 4000 characters.)
      
C1
*Are you a serving or retired member of the clergy?

      
C2
Retirement Date

      
C3
*Current/Former Diocese

      
C4
*Current/Former Parish

      
C5
Current/Former position

e.g. vicar, priest in charge, assistant curate, chaplain etc
      
C6
*Ordination Date

Please enter the month and year of your ordination as a deacon
     ?
D1
*Are you divorced/separated from or the widow(er) of a serving/former member of the clergy?

      
D2
*Full Name

      
D3
*Date of Birth (dd/mm/yyyy)

      
E1
*Do you have any children?

      
E2
Details of all dependant children (infants or children in full-time education).

Name Date of Birth Current school, college or university Details of course Expected leaving date (mm/yy)
  ?
E3
Details of all other children (whether living with you or not)

Name Date of Birth Occupation
   
E4
If anyone other than your spouse/ partner/children lives with you, please give details.

      
F1
Please enter your gross annual stipend/salary.

Income Self (£) Spouse/Partner (£)
Stipend
Salary
Maintenance
  ?
F2
Please give details of pensions.

Please enter the gross annual amounts of any pensions received
Pensions Self (£) Spouse/Partner (£)
Church pension
State pension
Other pension
   
F3
Please give details of any other income. Please supply details of what this income relates to in your narrative.

Please enter the gross annual amount of any other income. Please supply details of what this income relates to in your narrative.
Other Income Self (£) Spouse/Partner (£)
Bonuses/Dividends from Stocks & Shares
Payments from Trust Funds / Annuities
Any other income
   
G1
Please give details of any state benefits received. Only enter numbers in these fields, please do not enter commas or any other characters. 

Please enter the gross annual amounts of any state benefits received
State Benefits Self (£) Spouse/Partner (£)
Child Benefit
Universal Credit
Working Tax Credit
Child Tax Credit
Pension Credit
Council Tax Benefit
Housing Benefit
Jobseeker's Allowance
Employment & Support Allowance
PIP/Disability Living Allowance
Attendance Allowance
Carer's Allowance
Any other State Benefit
  ?
H1
*Do you live in a parochial house or other tied housing?

As you've answered 'Yes' please click Next
      
H2
If you do not live in a Parochial House or Tied Housing then please provide your annual outgoings relating to the property that you live in.

Details Amount (£)
Annual rent payment
Annual mortgage payment
Annual Council Tax
Purchase Price
Mortgage Outstanding
  ?
I1
*

Do you or your spouse/partner own a house or flat other than your main residence?

(NB: You do not need to enter details of any properties owned by separated spouses/partners).


      
I2
If 'Yes' please enter details about your property

Details Amount (£)
Purchase price
Current market value
Annual mortgage payment
Mortgage outstanding
   
I3
Please provide the date you acquired your property (mm/yyyy)

     ?
I4
*Is the property rented out?

      
I5

If 'Yes' please provide details about your rental property.

 


Details Amount (£)
Gross annual rental income
Annual letting agent's fees
Buildings insurance
Gas certificate
   
I6
First line of the address of the property you own

      
I7
Postcode

      
J1
*

Do you or your spouse/partner own a second property?

(NB: You do not need to enter details of any properties owned by separated spouses/partners).


      
J2

If 'Yes' please enter details about the second property that you own.


Details Amount (£)
Purchase price
Current market value
Annual mortgage payment
Mortgage outstanding
   
J3 Date your second property was acquired
     ?
J4
*Is the second property you own rented out?

      
J5

If 'Yes' please provide details about your rental property.


Details Amount (£)
Gross annual rental income
Letting agent's fees
Buildings Insurance
Gas Certificate
   
J6
First line of the address relating to the second property you own

      
J7
Postcode

      
J8
*

Do you or your spouse/partner own more than 2 properties?

If so please see below:


If 'Yes' please send us details of all your properties by post to: Sons & Friends of the Clergy, 1 Dean Trench Street, London, SW1P 3HB
     ?
K1
Please complete with details of ALL current assets for yourself and your spouse/partner.

Details Self (£) Spouse/Partner (£)
Current account balance
Bank/Building Society savings
ISA
ISA
Stocks & Shares
Stocks & Shares
Other investments
Other investments
   
L1

Please complete the table with details of any borrowings in your name and/or your spouse/partners name e.g. credit cards, bank overdraft/loans, car loan, HP, family loans etc.

Please do not include Student Loans


Lender Purpose Amount Outstanding (£)
  ?
M2
Please upload your supporting documents.

        
M1
Please upload your supporting documents.

We need supporting documentation for all income sources (e.g. stipend, salary, pensions, state benefits etc). Please do not upload P60's/Tax Returns-we need to see current information. HMRC Child Tax Credits paperwork - current year.
        
M3
Please upload your supporting documents.

        
M4
Please upload your supporting documents.

        
M5
Please upload your supporting documents.

        
N1
Bank/Building Society name

      
N2
Account holder's name i.e. Mr John Smith

      
N3 Account Number
      
N4
Sort Code

Please enter a six digit Sort Code with no spaces or separating characters
      
O1

Tick this box if you are in work and in receipt of any of the following means-tested benefits and you have savings in excess of £1,000:

Employment Support Allowance/Jobseeker’s Allowance

Housing Benefit

Council Tax Support

Pension Credit

We ask this to ensure that any discretionary gift that the charity may award you does not affect your entitlement to means-tested state benefits.


      
O2
If you are applying for or have received financial help from any other body (e.g. diocese or charitable organisation), please give details.

      
P1
*

I hereby give my explicit consent for Clergy Support Trust to store my personal information in line with the privacy statement which I have read.


      
Q1
*I certify that I have fully and correctly completed this form to the best of my ability and belief and given all relevant information to enable my application to be considered.

      
Q2
If you have not uploaded your documents, please tick to confirm that you will be sending all of your supporting documents, relating to your income, by post, within 10 days of submitting your application e.g.most recent Stipend/Pension slip, HMRC Child Tax Credit Award Letter(all pages for the current year), PIP, DLA, Carer's Allowance, Council Tax & Housing Benefit Award letters, any other income documents.

      
Q3
Please provide any feedback that you have regarding the application process

      
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