Make a Referral

This form needs to be completed by or on behalf of the applicant. Please complete this form as soon as possible to ensure WAN is aware of your applicant's circumstances.

Referring Organisation

Please provide the name and contact details of the referring organisation.

Who should we contact regarding this referral.

Applicant Information

Please provide the applicant's name, contact information and requirements.

Eligibility Criteria

Please confirm the applicant's eligibility criteria, or any exceptional circumstances.

Indicate relevant criteria by listing the guidance numbers here e.g 1,2,3,7

Guidance for Referring Organisations

Basic principles. It is considered that there are some basic principles that should guide referring organisations when considering requests and these are set out below.

  • The referring organisation has a responsibility to establish and decide on the need of someone for urgent food support
  • The referring organisation should use their discretion, judgement and compassion as well as the guidance set out below in reaching a decision to make a referral
  • The person or persons being referred should be in a state of food poverty i.e.  having minimal food and insufficient means to purchase adequate food or be at imminent risk of being in that situation
  • The position of those being referred should be the result of an identifiable, current hiatus or crisis
  • The circumstances of the individual(s) should be known directly to the referring organisation or the organisation should be able to assess the needs of members of the public and securing confirmatory evidence (where appropriate)
  • The individual(s) are not already in receipt of foodbank assistance or have not received such assistance in the previous three months, unless specific arrangements for further support have been made with the foodbank.

Eligibility Criteria. The following are suggested as reasonable possible criteria which referring organisations can consider before referring an individual or family for foodbank support. The list below is not exhaustive but will offer referring organisations more support in establishing the needs of the individual/family.  Please enter the reference number below on the referral form.

  1. Have been made redundant
  2. Have reduced working hours
  3. Loss of one income in a family normally with two incomes
  4. Delay in receiving income having started a new job
  5. In receipt of a low income or are in debt
  6. No other recourse to public funds
  7. Unforeseen costs or bills for an essential service or household amenity, e.g. broken down heating system/household fire have left individual/family with no money
  8. Recent change in circumstances has affected entitlement to benefit or significantly reduced the amount received
  9. Payment of benefits has been delayed
  10. Turned down for a crisis loan
  11. Ill health
  12. Returning home after an extended stay in hospital
  13. Domestic abuse
  14. Taking on unexpected caring responsibilities for a period
  15. Homeless