Welfare support referral form

Please use this referral form to refer individuals into our Starter Pack or Acts 435 services.

Referrals must be made by one of our recognised referral agencies. If you would like to discuss becoming a recognised referral agency, please contact Ben before making a referral.

More information about services:

Acts 435 support aims to crowd-fund support for people of up to £150 (or £200 for some items) towards specific household equipment, white goods, furnishings, essential furniture, court or debt relief order fees, clothing or other specific needs. We accept referrals for individuals or families who are (or have recently been) homeless or vulnerably housed - for example those moving from homelessness into a property, or those who need items such as beds or white goods which most people would expect to have in their home, but they cannot afford. Please note that because Acts 435 support is crowd funded, ...
Starter Packs are for people moving into tenancies from hostels or the streets, and contain bedding and household items. They help give guests moving on from our Winter Shelter, and other individuals moving from short-term hostels or rough sleeping, a brand new start and a brighter future. Many new tenancies fail in the initial stages because of a lack of financial resources that provide the basic household items that sustain tenants in their new property. Think of trying to keep a flat clean when you can’t afford basic cleaning products, trying to cook without any pots and pans, or getting ...
Warm Homes Healthy People is a free service which helps people who are homeless, vulnerable or poorly housed to keep warm, through information and advice, emergency practical support and small energy efficiency measures. What is available Through a number of voluntary and community organisations, eligible households are able to access: repairs to existing heating systems emergency heating bedding, clothing and emergency food advice on energy bills, grants and discounts advice on heating debt and benefits advice home energy checks energy efficiency measures such as light bulbs, draught-proofing and lagging. Inn Churches delivers the practical support element, providing food, bedding and ...

Important notes

Please note that Starter Packs and Acts 435 crowd-funding are only available once each to any individual, and if a referral is accepted it must be collected / processed by the referral agency and not the person being referred.

Starter Packs

Starter Packs are funded by charitable giving and therefore we are only able to offer them to single individuals moving from rough sleeping or temporary shelters/hostels to their own tenancies.

Referrals made by Thursday morning each week should be available from the following Tuesday (Wednesday if there’s a bank holiday). Referrals made after that will take another week. A collection date will be confirmed by email at the end of each week for referrals available from the following Tuesday.

Once a referral has been confirmed, the Starter Packs must be collected from The Storehouse by you as the referring agent (not just the applicant themselves, although you can bring them). To collect your starter pack you will need to confirm the referral number and the client’s name.

You will be notified when your pack is ready to collect – please do not try to collect before then. Collections should be made during office opening hours and we recommend contacting the office to check that somebody will be there, before collecting.

Starter Packs must be collected within two weeks of being notified, or you will have to make a new referral.

Acts 435

Acts 435 referrals should be for a specific, costed, item (or items), up to the maximum value below. Please cost your item(s) and apply for the actual amount required rather than just the maximum value allowed.

Referrals will be refused or delayed if they:

  • exceed the maximum values below
  • do not specify an item (or items) which can be purchased for the value being applied for
  • list a range of items needed which exceed the amount being applied for (unless you can confirm that funding is in place for all of the items).

If you are applying for money towards a larger cost you must have the rest of the funds secured first.

Not following these guidelines will delay your application.

Requests should not generally exceed £150, and the limits given are maximums – please obtain items more cheaply if possible:

  • Cookers, washing machines, fridge freezers: £200
  • Fridges, freezers: £175
  • Clothing: £120
  • Vacuum cleaners, mobile phones: £100
  • Microwaves: £75
  • Furniture, furnishings or other items: £150

You, as the referral agency, will be responsible for ensuring that the money is spent promptly on the item requested and receipts provided for the full amount. This is a condition of the funds being awarded and failure to provide a receipt may result in the funds being withdrawn. Receipts should be returned within two weeks, permission should be sought if it will take more than a month, and if funds are not spent within two months then funding will be withdrawn.

Acts435 is a crowdfunding service and is not guaranteed. Successful funding usually takes at least 3 weeks to obtain, and may be longer (or not at all). We do not take referrals for bonds or rent payments.

The referral

    This form should be completed by an individual working at a recognised referring organisation (the "referring agent") on behalf of the intended recipient (the "applicant").

    Fields marked * are required.

    Referrals being made

    Please select one or both options: *

    Recipient / applicant details

    Please give details of the intended recipient / applicant. This is the details of the client who is in need, not your details as the referrer.

    Starter pack referral


    Please tick required items and select size.

    DuvetBedding setPillows

    Household items

    Please tick required items.

    Crockery, cutlery, pans and utensilsKettle

    Acts435 referral

    Referring agent

    Please give your details.



    This should be completed by you as the referring agent.

    I confirm that the applicant named above is in genuine and urgent need, is unable to obtain these items from another source at this time.

    I confirm that the applicant has given consent to have these personal details shared with Inn Churches and Acts 435 and that they understand that their story will appear anonymously on the Acts 435 website for people to donate towards. I also confirm that the applicant has agreed to the sharing of any sensitive information such as racial or ethnic origin, criminal offences committed, or physical and mental health.

    I commit to returning receipts for the purchase(s) within two weeks if possible, and to requesting permission if they will not be returned within a month. I understand that if receipts are not returned within two months then the funding may be withdrawn.

    Diversity monitoring

    This information is optional and for monitoring purposes only. It will not be considered when assessing the referral.