Name

First Name

Last Name

Do you still intend to apply for help from Addington Fund?

Yes and I will complete the application form shortly

No

If you no longer intend to apply for help, please tell us why (please tick as many as apply)

I no longer need financial assistance/the problem has resolved itself

I do not understand how to complete the application form and would appreciate some help

I cannot provide evidence of my eligibility as a farm worker

After reading the applicant criteria I do not think I am eligible