Community Response Application form
Wycombe Refugee Partnership are able to help getting donated household goods including furniture, bedding, kitchen equipment and other normal household items.  We can also help provide good quality second-hand clothing.  We are open to requests and will do our best to procure them through our Facebook group and other community contacts.  We do not give cash however sometimes we give supermarket vouchers, depending on funding.

WRP can also help with food support referrals, and sometimes help directly with food support depending on current grant funding. We can help with signposting to English classes around Wycombe, volunteering opportunities and to other free and friendly community groups.  We have volunteers who speak fluent Arabic, Urdu, French and Malayalam.

If you are referring someone else, please fill in as much information as the Applicant is happy sharing.  This helps us to know their current situation and how best to help them.  
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Are you completing this form, with permission, on behalf of someone else? *
Your name *
Your organisation *
Your contact information *
First name *
Family name *
Have you been known by any other names *
If yes, please provide details
Are you (please select) *
Date of birth *
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Contact address (including postcode) *
Date you moved to this address *
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Phone number *
Email *
Nationality *
Which other organisations are helping you? *
Do you usually need an interpreter? *
What languages do you understand? *
How many other adults (not including you) are there in your family? *
1. Adult name
Adult gender
Clear selection
Adult date of birth
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YYYY
2. Adult name
Adult gender
Clear selection
Adult date of birth
MM
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DD
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YYYY
How many children are there in your family?
1. Child name
Child gender
Clear selection
Child date of birth
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/
DD
/
YYYY
2. Child name
Child gender
Clear selection
Child date of birth
MM
/
DD
/
YYYY
3. Child name
Child gender
Clear selection
Child date of birth
MM
/
DD
/
YYYY
4. Child name
Child gender
Clear selection
Child date of birth
MM
/
DD
/
YYYY
If you have more than 4 children, please add their names, gender and date of birth
Please list below any special needs in the family (e.g. disabilities, language, etc.) and anything else you wish to tell us.
Salary / earnings:
Universal Credit / other benefits or grants:
Asylum support:  How much money do you receive per week?
Does the Home Office provide your accommodation?     *
Do you pay rent for your housing?
Clear selection
Do you have help from friends or family? *
What help are you asking us for? *
If you agree, please circle one or more of the choices below to show how we may contact you
Please click SUBMIT to send your form to us. After that, please email a copy of both sides of your ID document (ARC card or BRP card) and proof of address (if available) to communityresponse@wycombe-refugees.org.  We will contact you very soon.
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