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BDA Benevolent Fund Application Form

64 Wimpole Street, London, W1G 8YS

0207 4864994
generalmanager@dentistshelp.org
www.bdabenevolentfund.org.uk


GUIDANCE FOR APPLICANTS - Please read prior to completing the application form.

 

We have tried to make asking for help as simple as possible. Below is some extra information about how we work to assist you with completing the form.

 

How do I get help from the British Dental Association (BDA) Benevolent Fund?

You have to complete and return a form, giving details about your circumstances and particularly your financial information such as income and expenditure, any savings, assets and debts. Please fill out the form to the best of your ability. The form should be submitted along with copies of your bank statements covering the last three months. We cannot consider your request without this. The form and supporting information can be sent in the post or electronically.

 

Please answer the details on the form as fully as you can, which will help us to speed up your request.

 

What happens to my application form after it has been sent in?

It will be processed by the General Manager. A follow up phone call will be made to make you aware that the application has been received and to go through some of the details. Should you be eligible, your application will be taken to the next meeting for consideration along with a recommendation based on what need you have identified. You will be informed of any timescales. You may be visited by the General Manager or a local volunteer to help you with the process (if you request this) and/ or an opportunity to clarify information and receive face-to-face support.

 

What happens if I cannot wait until the next meeting or need emergency help?

We would not keep anyone waiting for a decision longer than is necessary and by providing all the relevant information, we aim to assist you either we support or with information about when your request will be considered within 72 hours.

 

Is my application confidential?

All the information send in and discussed is confidential and will be only be viewed by the people who are processing and deciding upon your request.

 

What happens if my application is unsuccessful?

We cannot consider requests that haven’t verified their information by providing their bank statements. Requests may not be granted when it considered that your income is enough to meet your needs and/ or you have significant savings. We are also unable to assist with funds towards business costs, private health care, private school fees, legal fees (with the exception of bankruptcy/ debt relief related expenditure) or large debts.

 

If your application is turned down, your data will be removed and shredded. You can appeal any decisions by putting a request in writing to the Chairman via 64 Wimpole Street, London, W1G 8YS or emailing generalmanager@dentistshelp.org.  You are welcome to re-apply at any time should your circumstances change.

 

If we are not able to help, we may be aware of other organisations that are more relevant or better equipped to assist you.

 

We look forward to receiving your application





This application must be submitted with bank statements covering the last three months.
Applicant Details





DD/MM/YYYY









      Name    Relationship to you      Date of birth     Where living
Dependent 1
DD/MM/YYYY
Dependent 2
DD/MM/YYYY
Dependent 3
DD/MM/YYYY
Dependent 4
DD/MM/YYYY
The BDA Benevolent Fund supports dental students who are living in the UK and in financial need i.e. facing undue hardship. Please give details of your qualifications and employment history so we can verify your eligibility. 
University Name     Course Name     Date attended
DD/MM/YYYY
DD/MM/YYYY

Current employment (if applicable)




DD/MM/YYYY

Other sources of help/ income



DD/MM/YYYY


What assistance are you seeking and why?


Income and expenditure


Please complete the below information as systematically and accurately as possible ensuring all figures are ANNUAL covering the current academic year (i.e. September – August). 

Income 
Please enter figures only e.g. 12000












EXPENDITURE
Please enter figures only e.g. 12000












Permissions and declarations

 

The BDA Benevolent Fund is committed to safeguarding your privacy and it will take every precaution to protect and ensure your information remains confidential and within data protection rules and legislation.

 

Please read the full statement and terms and conditions and sign to demonstrate your agreement.

·       The details I have given in this form are correct to the best of my knowledge and that my application can be refused or delayed if there are discrepancies.

·       I will inform the BDA Benevolent Fund of any change in circumstance throughout the processing of this application.

·       I understand that the information expressed in this form will be kept confidential and to only be used to make an informed decision.

·       I consent to my personal data being processed and maintained by the BDA Benevolent Fund for the purposes of administering my application.

·       I understand that the form and supporting information will be kept in accordance with the BDA Benevolent Fund’s retention policy, which can be found on our website and/or requested from the office.




Please provide bank statements covering the last three months
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