I need help with my finances

Your details

First name*

Last name*

Date of birth*

Preferred pronouns*

Phone number*

Email address*

I am:
—Please choose an option—Currently working in an NHS ambulance serviceCurrently working in an independent ambulance serviceRetired and used to work in an NHS ambulance servicea Paramedic Science studenta UK ambulance service volunteerNone of the above

Please provide details of your current employment/education/volunteering status, including your job title, employer and length of service.*

If you're currently off work or on reduced/alternative duties due to illness or injury, please provide detail below.

I live in*:
—Please choose an option—a property I owna property I am privately rentinga housing association or a local authority propertysheltered accommodationa residential or nursing homeno fixed abode

Please provide details of all your current dependents. This includes all children under the age of 18 and anyone you have a caring responsibility for.*

Support from TASC

TASC is able to provide a range of financial support, please use the tick boxes below to confirm what support you'd like to recieve.

Please note that we're currently unable to provide financial grants, howvever we can provide a benefits check to see if there are other sources of support you may be eligible for, such as Universal Credit.

Would you like general financial guidance?—Please choose an option—YesNo

Would you like a benefits check?—Please choose an option—YesNo

Would you like debt advice and support?—Please choose an option—YesNo

Please provide as much detail about your current situation as you can to help us understand how we may be able to help you.*

  I confirm I have read TASC’s eligibility criteria and confirm that I am eligible to receive support from TASC

How did you hear about TASC? —Please choose an option—EmployerManagerColleagueFriendTASC volunteerPoster/leaflet/flyerNews articleWebsiteOnline searchSocial mediaAdvertOther

Diversity

The below questions below are optional and will help us understand who is accessing TASC’s support and how we can develop our services to reach more of the ambulance community.

What was your sex at birth?—Please choose an option—FemaleMalePrefer not to say

What do you identify as? —Please choose an option—FemaleMaleNon binary/gender fluid/gender queerTrans femaleTrans malePrefer not to sayOther

What is your sexual orientation?—Please choose an option—AsexualBisexualHetrosexualHomosexualPrefer not to sayOther

What is your religion?—Please choose an option—AthiestBuddistChristianHinduJewishMuslimNo religionSikhPrefer not to sayOther

What is your ethnic group?—Please choose an option—ArabAsian - BangladeshiAsian - ChineseAsian - IndianAsian - PakistaniAsian - OtherBlack - AfricanBlack - CaribbeanBlack - OtherWhite - English, Welsh, Scottish, Northern Irish or BritishWhite - Gypsy or Irish TravellerWhite - IrishWhite - RomaWhite - OtherMixed - White and Black CaribbeanMixed - White and Black AfricanMixed - White and AsianMixed - OtherPrefer not to sayOther

Are you registered disabled?—Please choose an option—YesNoPrefer not to say