Mummy s Star Grant Guidelines

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Mummy s Star Grant Guidelines Overview Our grants programme is aimed at supporting families to provide some financial relief when most needed and provide some breathing space during what is a very difficult and challenging time. Filling in the form / Help We are fully aware of the stress and worry that families go through if they are unfortunate enough to find themselves needing to access our support. With that in mind we have designed a straightforward application form to avoid creating further unnecessary stress and worry. If at any point you have questions or require help filling in this form please do not hesitate to contact us at info@mummysstar.org, providing your phone number and we will arrange a convenient time to ring and discuss the application with you. Once completed, your application form along with proofs and Equality and Diversity monitoring form should be emailed along with the supporting documentation required or returned to the address below: Mummy s Star PO Box 428 Glossop SK14 9EA Eligibility In order to be eligible for our Mummy s Star Grants Programme you must fit under at least one of the following as the charity focuses on supporting women and families where the: Woman is diagnosed or treated for cancer during her pregnancy. Woman is diagnosed or treated for cancer within a year of her giving birth. Family in the first year of a birth lose their female partner as a result of cancer Note 1: If you are diagnosed with any form of cancer but then sadly the pregnancy cannot continue whether it be either natural or medically induced loss you are eligible for our support. We also support women who are diagnosed with a molar pregnancy or Gestational Trophoblastic Disease. Note 2: A child must be 12 months or younger at the time of application is received. Information Required to Support Your Application For us to process your application as quickly as possible please enclose a copy of the following with your application. Without these we are unable to begin processing your application: Medical confirmation of your diagnosis (a copy of a letter indicating your treatment/appointments relating to your diagnosis) Copy of Photo ID Passport or Driving Licence preferable together (if you do not have this then a copy of your birth certificate Proof of address - copy of a recent letter (e.g., bank statement, Council Tax statement). Grants

The maximum grant that can be applied for is 700. The only exception to this is if a secondary cancer is received in which case a higher amount will be considered for a short holiday break. The average grant approved is 500 Eligible Costs We do not provide an exhaustive list of what is eligible in our grants programme as every family has different needs and therefore each application will be judged individually. We always recommend speaking to us prior to applying to check and avoid any delays. These are just some examples of the types of things that may help families/have helped families in this situation: Recompense for partners having to take unpaid leave to support at home beyond their existing leave/paternity leave Private purchase of donor breast milk (if your hospital is unwilling to fund it) Travel costs to appointments Support which may help with bonding with new baby such as costs of baby massage classes etc. Payment for counselling support, telephone or face to face, if not available through your support services within a short space of time i.e. 3 months waiting Payment for additional child-minding required around appointments or payment for home childcare such as a nanny for a day a week etc. around appointments or post treatment days Payment for a cleaner in the home. An Ipad or similar device to allow children to speak to Mummy when she may be in hospital overnight etc. Holidays (in the case of a secondary cancer diagnosis) Prescription charges (Republic of Ireland only) Ineligible Costs While we would like to be able to provide every family with grants to support those things that will bring them the greatest relief, we do have to rule out certain costs to be able to support as many families as possible. The following items cannot be funded through a Grant: Cost of medical treatment Holidays (except if a secondary cancer diagnosis is received) Purchase of vehicles Purchase of non-essential electrical equipment for the home Payment of Rent or Mortgage Payments, Interest payments (e.g., on unsecured debt), TV licence fees etc. Prescription charges (except in Republic of Ireland) Costs for services and items covered by benefits Making a Decision/Timescales Upon receipt of your application and it being checked, the form is then circulated to our trustees for a decision. Decisions are made simply by majority and in the event of a tied vote; the Chair will make the casting decision. The normal timescale for this is 2 weeks unless received during the months of July and August at which time several trustees may be away. You will be notified within one week of the decision in writing or via email dependant on your preference. If you have been successful we aim to make payment within one week.

Applying again Due to high demand, we can only provide one grant per family in any 12-month period and a maximum of 2 grants in total to any one family over time. The only exception to this is if a secondary cancer or terminal diagnosis is received. Unsuccessful Applications In the event that your application is unsuccessful, we will work with you to identify other sources of funding for the items in your application. If reapplying, any new application must be for something different to that on the previously unsuccessful one. We recommend you contact us prior to resubmitting an application. Receipts/Evaluation Form If you are successful in receiving a Mummy s Star Grant, we will write to you 12 months after. At this point we will ask you to fill in a simple evaluation form confirming what the grant was spent on and what relief this brought to you and your family and ask that you send us the receipts for any items purchased (where reasonable). Please note you will be asked on our evaluation form if you are happy for us to share your comments on our website/for use in publicity material. The purpose of this is so we can publicise, with your permission, the benefits that the Mummy s Star Grants provide.

Mummy s Star Grant Application Form Before filling in this form please ensure you have read our accompanying guidelines above. All information recorded is treated as confidential and will not be shared with anyone apart from the Trustees and Advisors of Mummy s Star for making a decision. 1. Name 2. Address 3. Email Address 4. Contact Number 5. Date of Birth 6. If it is someone other than a member of the immediate family completing this form please give details of who you are, contact details and your role in supporting this family i.e. health professional, friend etc. 7. Please tell us about your circumstances 8. Please explain to us what you would like a Grant to pay for

9. Please break down the costs you have indicated in the previous answer 10. Please describe the benefit that this will bring to you and your family Item/Expenditure Cost Total Cost 11. How did you hear about Mummy s Star? 12. Signature of Applicant Date 13. Print Name Please note if your application is successful then you are agreeing to use the grant for the agreed purpose within a 12-month period. Any change in the planned use of the grant must be agreed prior, by notifying Mummy s Star in writing via email or otherwise. Any proposed changes will be dealt with as quickly as possible. For payment by BACS/Cheque Payment Details Name of Account Holder/Made Payable To Bank Name & Address Account Number Sort Code International Bank Account Number (IBAN) Bank Identifier Code (BIC) For Mummy s Star Use Only Reference No. Date Received Date Considered Trustee Decision Applicant Notified Amount Awarded Payment Made E&M Received

Equality and Diversity Monitoring Mummy s Star aims to provide equal opportunities and fair treatment for all. Please complete the form and return with your Grant Application. The information below is anonymous and not held with your casefile. All details are held in accordance with the Data Protection Act 1998. We would like you to complete this form in order to help us understand who we are reaching and to better serve everyone in our community. If you would like the form in an alternative format or would like help in completing the form, please contact a member of staff. Ethnicity Please state what you consider your ethnic origin to be. Ethnicity is distinct from nationality and the categories below are based on the 2001 Census in alphabetical order. Asian Black Chinese or other ethnic group Indian Caribbean Chinese Pakistani African Any other ethnic group Bangladeshi Any other Black Any other Asian Mixed White and Black Caribbean White and Black African White and Asian White English Irish Scottish Welsh Any other mixed Any other White Age:

Gender Male Transgender F to M Female M to F Faith Which group below do you most identify with? No religion Baha i Buddhist Christian Hindu Jain Jewish Muslim Sikh Other Sexual orientation How would you describe your sexual orientation? Bisexual Gay man Heterosexual or straight Lesbian Other Disability The Disability Discrimination Act 1995 (DDA) defines a person as disabled if they have a physical or mental impairment which has a substantial and long term (i.e. has lasted or is expected to last at least 12 months) adverse effect on one s ability to carry out normal dayto-day activities. This definition includes conditions such as cancer, HIV, mental illness and learning disabilities. Do you consider yourself to have a disability according to the above definition? Yes No