Community First New Forest

...building relationships, enabling action!

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PIN Search Checklist

This is a checklist for collecting information from people in need before running a PIN search on their behalf. It does not collect the information in exactly the same order as the order of screens in the program.

If you do not wish to fill this form in online, you can download the printable PDF File.

Name:

Email Address:

Age:

Gender

Male
Female

Marital Status

Single
Married or Co-habitating
Divorced
Widower

People under 25:

Adopted
Orphan

1. Basics

A. What do you want money for?

Education or career development
Welfare

b. What specifically do you need funding for?

Welfare only

Pension/Annuity
Nursing Home/Day Care Fees
convalescence/respite care
Rent
Council Tax
Fuel/Water Bills
HP or Loan Repayment
Debts/Fine
Property
Furniture/Fittings & White Goods
Funeral/Headstone
Pilgrimage

Clothing
TV Licence
TV or Radio
Telephone
Computer
Medical Treatment
Disability/Medical Equipment
Car/Car Licence
Travelling Expenses
Holiday in UK
Holiday/Travel Abroad
Something Else

Education only
Are you looking for money to study a particular subject, profession or career?
If "YES" what subject(s)

OR
Are you looking for funding for a gap year, other personal development project, business or work start-up etc not related to a specific subject?

Yes
No

Level of education:

School Children Only:

State
Private

Study Need:

Fees
Exam Fees
Living Expenses
Travel/School Outings
Books/Equipment
Musical Instruments

Uniform/Clothing
Childcare or care of Adult
Exchange Visit
Study/Travel Abroad
Expeditions
Something else

2. Links with a particular place

Main Address

Term Time Address

a. Where do you currently live?

(students may have 2 current addresses, their term time address and their home address)

b. What other links do you have to places?

Born in:
At school in:
At college/university in:
Work/ed in:
Other places lived in:

3. What is/was your occupation?

Current:

Former
(now do something else):

Former (now retired):

4. Are you serving in, or have you served in the armed forces?

If YES, which branch/regiment

Current
Officer
Former (now do something else)
Retired
Other rank

5. Do you regularly attend a place of religious worship?

If YES which religion:

6. What is your nationality?

Nationality:

Are you a refugee or asylum seeker?

Yes
No

7. Are you disabled?

If YES, please give details:

8. Are you sick/ill/frail?

If YES, please give details

9. Other characteristics

Socially, Economically or Environmentally Disadvantaged
Child or Young Person who is Deprived, Neglected or at Risk
Homeless
Housebound
Misuser of Alcohol or Drugs
Unemployed
Mother/Expectant Mother
Single Parent
Child from a Single Parent Household
Is or has been in care
Family experiencing breakdown or difficulty
Offender, Ex Offender or family of a Prisoner
Young Person at risk of Offending
Victim of Aggression
Victim of Physical, Sexual or Mental Abuse
Victim of The Troubles
Someone Persecuted for their beliefs
someone affected by the events of "9/11"
Someone who has suffered as the result of a Fire"
Someone who has acted bravely in a Fire"
A Hero or dependent of a Hero"

If time is limited, questions 1 and 2 are the key questions and provide enough to run a search. In question 2, entering the place where the person currently lives is sufficient.

Other members of the family

People can sometimes get grants because of members of their family. For example there are a number of charities for the dependents of people who worked in particular jobs or were members of certain trade associations. Or people can get grants because they look after someone who is disabled or ill or frail.

Looking at questions 2-8, are there any members of your family that you think it might be worth providing information about? If so please provide relevant details.

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