Welfare support referral form

Please note that to make referrals your organisation must be registered as a referral agency with us – please contact ben@innchurches.co.uk for a registration form.

The Acts435 service is currently very busy and typical wait times are six weeks.

Please use this referral form to refer individuals into our Starter Pack or Acts435 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 us before making a referral.

More information about services:

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Acts435 support aims to crowd-fund support for individuals of up to £150 towards specific household equipment, white goods, furnishings, essential ...
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Starter Packs are for people moving into tenancies from hostels or the streets, and contain bedding and household items. They ...
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Important notes

Please note that Starter Packs and Acts435 crowd-funding are only available once each to any individual, and if a referral is accepted it must be collected by the referral agency and not the person being referred.

Starter Packs

Please note that 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 can take up to a week to be processed. You will be notified when your pack is ready to collect – please do not try to collect before then. Collections should ideally be made between 8am-4pm Tue-Thu.

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


Acts435 referrals should be for a specific, costed, item (or items). The maximum amount is £150 for a high-value costed item (eg. large furniture, white goods) or £120 for other items. If you are applying for money towards a larger cost you must have the rest of the funds secured first. Please cost your item(s) and apply for the actual amount required, rather than simply applying for the maximum amount, to be fair to other applicants. Not following these guidelines will delay your application.

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.

We can only process one Acts435 referral per referrer at a time, and we do not take referrals for bonds or rent payments.

Acts435 is a crowdfunding service and is not guaranteed. Successful funding usually takes at least 3 weeks to obtain, and may be up to 5 (or not at all).

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: *

    Applicant details

    Please give details of the intended recipient.

    Starter pack referral

    Starter Pack items requested

    Please note that Starter Packs are for individuals, not families. Pack contents may vary due to availability and may include good quality donated items.


    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.

    Diversity monitoring

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

    Please note that our warehouse, café and offices are restricted to visitors. More details