Apply for assistance

To find out if you’re eligible for assistance, fill out this form
giving us as much detail as possible and a member of the
support team will contact you.

Name/Surname

Phone number

Email address

Are you applying for yourself?

If no, full name of proposed guarantee

Yes

Applicant's Employment in the Footwear Industry*

Name/Address of employer

Name of line manager/supervisor

From/To

Sector

Name/Address of employer

Name of line manager/supervisor

From/To

Sector

Name/Address of employer

Name of line manager/supervisor

From/To

Sector

Name/Address of employer

Name of line manager/supervisor

From/To

Sector

Basis of application

Please tell us about your circumstances and the reason you are applying for assistance

I'm not a robot

*Our charity specifically helps those who have been employed in the footwear trade for a minimum of five years. We cannot assist applicants from non-footwear sectors, however, there are similar charities associated with other trades. Citizens Advice may be able to assist you in finding the help you need.

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