"*" indicates required fields
Whether faced with an immediate bereavement or worried about future costs, we can support you to plan a meaningful funeral that is as affordable as possible.
Please note that we are unable to provide one-to-one support by e-mail or telephone when the funeral has already happened.
Please give your full name. If you prefer to be called something different, please let us know.
This is so that we can send you an acknowledgment of your referral.
It's helpful for us to know how people find out about us.
We usually recommend providing the contact details of the person arranging the funeral, as any financial support available is generally based on their circumstances and eligibility.
We'll now ask you to provide some information about yourself.
We need to collect some personal information from you to be able to support you. We will store your information securely on our database and only use your contact details to contact you about your case. We won’t share your information with anyone outside of our charity without your consent, unless we’re worried that the safety of you, or others, especially children, are at risk. Where possible, we will always try to discuss this with you first.
We'll now ask for some information about the person we should contact.
Please give their full name. If they prefer to be called something different, please let us know.
We need to collect some personal information from our clients to be able to support them. We will store this information securely on our database and only use contact details to contact the client about their case. We won’t share client information with anyone outside of our charity without consent, unless we’re worried that someone's safety is at risk. Where possible, we will always try to discuss this first.
One of our team will call you to see how we can help.
Please provide your address
Please tell us your contact details.
If you provide an e-mail address. you will receive an acknowledgment of this referral by e-mail.One of our team will call you to see how we can help.
Please provide your telephone number
Please tell us the person we should contact's contact details.
One of our team will call them to see how we can help.
Please tell us the person we should contact's address.
Some support available is dependent on the age of the person applying, so this is helpful to know.If you would prefer not to answer this question, you can leave this blank.
We ask this question because some support options are gender-specific. If you would like, please also let us know your preferred pronouns.If you would prefer not to answer this question, you can leave this blank.
This helps us to ensure we are reaching all communitiesIf you would prefer not to answer this question, you can leave this blank.
This helps us to help you. For example, we can arrange an interpreter if needed, or ensure that written communications are in large fonts.If you would prefer not to answer this question, you can leave this blank.
Some support available is dependent on the age of the person applying, so this is helpful to know.If they would prefer not to answer this question, you can leave this blank.
We ask this question because some support options are gender-specific. If you would like, please also let us know their preferred pronouns.If they would prefer not to answer this question, you can leave this blank.
This helps us to ensure we are reaching all communitiesIf they would prefer not to answer this question, you can leave this blank.
This helps us to help them. For example, we can arrange an interpreter if needed, or ensure that written communications are in large fonts.If they would prefer not to answer this question, you can leave this blank.
We'll now ask you some questions about the person the funeral arrangements will be for.
Please give their full name. If you prefer us to call them something different, please let us know.
If you would like, please also let us know their preferred pronouns.If you would prefer not to answer this question, you can leave this blank.
To help us understand what kind of support may be most helpful, it would be useful to know a little about the situation. If you’re able, please tell us what you’ve been told about this person's health or prognosis, or if you’re planning ahead without one.
You might like to tell us more about the prognosis given (if applicable), any arrangements you've made already, or something else.
To help us understand what kind of support may be most helpful, it would be useful to know a little about the situation. If you’re able, please tell us what you’ve been told about your health or prognosis, or if you’re planning ahead without one.
You might like to tell us more about your prognosis (if applicable), any arrangements you've made already, or something else.
We'll now ask some questions about the person who has died.
We'll now ask for some information about the person who has died.
For example: partner, spouse, mother/mum, father/dad, etc.
You might like to tell us when the funeral is, how much it is costing, or something else.
Select Submit to send your answers and see the next steps.