Application

Apply For Help

To apply for charitable help from the Jim Cousins Trust, please complete the form below, then click on the “Submit” button.

An individual application is only for those who live in Witney or nearby.

Note

The form below requires you to include a letter from a recognised professional to backup your application, together with income/expenditure details. You may attach Word documents to the form (or use a similar document format).

Application Form

All fields marked * are required.

Your Name (in full)

Your Email Address

Your Phone Number

Your Address

Please Describe What Your Application Is For

Documents to support your request

Please include a letter from a recognised professional (e.g. Doctor) together with income/expenditure details. You may upload more than 1 document.

Up to 5 files, each no larger than 5MB and 15MB in total: Word (.doc, .docx), PDF, OpenDocument (.odt), RTF, text, or photos (.jpg, .png, .heic). To choose more than one file, hold Ctrl (or Cmd on a Mac) while you click.

Your application and documents are sent to the Trust by email. See our privacy notice.