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Household referral

Referral form for social workers to register a household for a food parcel.

This form needs JavaScript to check that a person sends it. Without it, sending does not work.

Who is referring?

Referrer name

Referrer organisation

Referrer email

The household

Household contact person

Name of the household's contact person.

Household phone

Household email

The request for help

Type of help

Food parcel

Note on the request for help

How we use your details

Purpose: Contact details of the household and the referrer, used to assess the request and to arrange the weekly parcel pickup. Data is not shared outside the organisation.
Lawful basis: Your consent
How long we keep them: 2 years after the last contact, then anonymised

I agree that my details are used for: Contact details of the household and the referrer, used to assess the request and to arrange the weekly parcel pickup. Data is not shared outside the organisation..Required

Household referral

Who is referring?

The household

The request for help

How we use your details

Your consent