Home/ Resident/ Benefits and grants/ Welfare reform/ Apply for Welfare Support and Welfare

Apply for Welfare Support and Welfare

All fields with * are mandatory and should be completed in full.

Applicant Details

Are you completing this form for yourself or on behalf of somebody?

Yourself
On behalf of somebody

Referrer Details

Are you completing this as an organisation or individual?

Organisation
Individual

Referrer First Name

Referrer Last Name

Organisation Email Address

Confirm Organisation Email Address

Job Title

Agency

Other Agency

Relationship to applicant

Applicant Details

You must provide up to date contact details so that we can email or call you regarding your application.

First Name

Last Name

Telephone Number

Email Address

Confirm Email Address

Date of Birth

Day

Month

Year

National Insurance Number I do not have a National Insurance Number

Ethnicity

Other Ethnicity

Applicant Address

Address Search

Additional address information i.e. "Room 1"

Welfare Support - What support do you need

Support with food

Please give full details why you require support with food

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Help towards energy and water payments

Please give full details why you require support with energy and water

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Who supplies your gas and electricity?

Other gas and electricity supplier

How do you pay for your gas and electricity?

Do you need help with household items?

We will only consider a claim for household items in genuine crisis. We do not replace through general wear and tear or damage and we do not provide white goods.

We can offer basic furniture items that are deemed essential requirements only for those who have been rehoused through homelessness or in an emergency as a result of a fire or flood and have no means to purchase/replace items will be considered. Please note all items supplied can be new or used but will be safe and without any risk.

Have you recently been rehoused through homelessness, domestic violence or in an emergency due to fire or flood in the last 2 months? - We will complete checks to verify the information that you have provided.

Please give full details of why you require support with household items?

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What household items do you require?

Have you made any other claims for Welfare Support in the last 12 months?

Has your income and/or outgoings changed since you last applied?

Have you tried to get any support from anywhere else?

Welfare Rights – Support, advice and guidance

Welfare Rights Service is a seperate service to our Welfare Support.

We offer free, confidential, specialist advice on welfare rights for people who live in Wigan and Leigh.

The focus of our work is on income maximisation by identifying potential benefit entitlement both from the local authority and wider DWP benefits. We focus on empowering people to know and claim their benefit rights.

We can help you work out what benefits you are entitled to, assist with claim forms, and support you with appeals if you disagree with a decision.

If you need support with debt, we can refer you to Citizens Advise for support.

Welfare Rights provide

Benefit entitlement advice
Assistance completing Wigan Council and Department of Working Pensions (DWP) benefit and discount forms (except for new Universal Credit applications)
Benefit refusal advice and assistance
Guidance on how to appeal benefit decisions
Advice on money management – prioritising and budgeting
Maximising your income via a benefit check to ensure you are claiming all that you are entitled to from the Council and DWP

Would you like specialist benefit and income maximisation advice and support from our Welfare Rights advice team?

Advice on money management – prioritising and budgeting support

Assistance with completing DWP Benefit forms

What form do you require assitance with?

What date does the form need to be completed by

Please advise the form you require assistance with

Advice and support on a range of Welfare Benefits

Do you need support with debt management?

We will complete a referral to Citizens Advice on your behalf.

Please provide information on what benefit advice you require from our Welfare Rights Team. If you are asking for Debt advice, please include your main worry about debt and how much this is

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