Language:
Cafcass Cymru

Working Together for Children (WT4C) financial assistance application form

 

About you

Your name: *

 

Your address:

 

Your postcode: *

 

Your contact number: *

 

Your email address: *

 

Your Cafcass Cymru representative

Their name *

 
Your case

Court reference number: *

 

Court name: *

 

Legal Aid

Have you applied for Legal Aid? *

 

(If yes) Please provide the reasons that you were unsuccessful in obtaining legal aid:

 

Financial details

Please provide your total monthly income: *

 

Please provide your total monthly outgoings: *

 

Please provide your total disposable income: *

 

Please provide details about the financial hardship you would suffer if required to pay the £150 cost of the Working Together for Children Course.
Please supply details of expenditure in this section. *

 
Please check that you have answered all of the questions, as we will not be able to consider your application if you do not provide all the information required.

Please read the statement below carefully before pressing submit.

Declaration by service user completing this form
I confirm that this is a true statement of all my income and outgoings and representative of an average month. I understand that if I tell you anything untrue in this form, or leave anything out my application will be rejected and the reasons for this rejection will be disclosed in a Cafcass Cymru report to the court. I may also be liable to pay for the costs of any Activity Programme. *