Online Form
Proceed
{"views":[{"type":"intro","toolbar":null,"title":null,"pageName":"wba_OnlineApplicationRegister","messagePropertyId":"vw_register","form_groups":[{"type":null,"title":null,"referenceTo":"f84a5712-51c8-4f07-aacc-05f88a9b117f","messagePropertyId":"vw_sec_begin","isTemplate":null,"form_field_sets":[{"type":"standard","referenceTo":"187e89fa-842a-45bd-9044-f1d55b953237","messagePropertyId":null,"form_fields_store":null,"form_fields":[{"values":null,"value":"<h4><span style=\"font-size:18px\">Thank you for applying to the Herefordshire Community Foundation Fuel Poverty Fund.</span></h4>\n\n<p><span style=\"font-size:18px\">This fund is to help with fuel costs for those people in need, living </span><span style=\"font-size:18px\">within Herefordshire and </span><span style=\"font-size:18px\">is up to a maximum of £500. </span></p>\n\n<p><span style=\"font-size:18px\">We only take applications from third party professionals i.e. Social Prescribers, Health Workers, CAB, DWP Work Coach, Support Worker. </span></p>\n\n<p><span style=\"font-size:18px\">Grants will only be given to those households most in financial need, it is therefore important to give as much detail as possible regarding circumstances.</span></p>\n\n<p><span style=\"font-size:18px\">Professionals supporting people who are experiencing financial hardship may find it useful to pass on the information found on the Talk Community website: </span></p>\n\n<p><span style=\"font-family:calibri,sans-serif; font-size:12pt\"><a href=\"https://www.talkcommunity.org/money-on-your-mind/i-am-in-debt-and-dont-know-where-to-turn/help-with-money-management/\">https://www.talkcommunity.org/money-on-your-mind/i-am-in-debt-and-dont-know-where-to-turn/help-with-money-management/</a></span></p>\n\n<p> </p>\n\n<h4> </h4>\n","type":"outputtext","suppressValidation":null,"required":null,"referenceTo":"df91b285-f828-46ea-bd0c-43939fbb16f2","numbr":null,"validation":null,"styleClass":null,"style":null,"size":null,"placeholder":null,"options":null,"multiple":null,"message":null,"maxLength":null,"label":null,"helpText":null,"editable":null,"data":null},{"values":null,"value":null,"type":"checkbox","suppressValidation":null,"required":true,"referenceTo":"Online_Grant_Application__c.Registration_Agreement_Understood__c","numbr":null,"validation":"val-chk","styleClass":null,"style":null,"size":null,"placeholder":null,"options":["I agree that I have read and understood the above"],"multiple":null,"message":null,"maxLength":null,"label":null,"helpText":null,"editable":null,"data":null}]}],"displaySeparator":true,"description":null},{"type":null,"title":null,"referenceTo":"25353a36-5552-4441-8189-c52ae93bb31d","messagePropertyId":"vw_sec_email","isTemplate":null,"form_field_sets":[{"type":"standard","referenceTo":"28e131c8-820d-4613-8cca-3b669ade7f94","messagePropertyId":null,"form_fields_store":null,"form_fields":[{"values":null,"value":null,"type":"text","suppressValidation":null,"required":true,"referenceTo":"Online_Grant_Application__c.Registration_Email__c","numbr":null,"validation":"val-eml","styleClass":"section-content-field-itext","style":null,"size":null,"placeholder":null,"options":null,"multiple":null,"message":null,"maxLength":"255","label":null,"helpText":null,"editable":null,"data":null},{"values":null,"value":null,"type":"hidden","suppressValidation":null,"required":false,"referenceTo":"Online_Grant_Application__c.Applicant_Id__c","numbr":null,"validation":null,"styleClass":"section-content-field-itext","style":null,"size":null,"placeholder":null,"options":null,"multiple":null,"message":null,"maxLength":"40","label":null,"helpText":null,"editable":false,"data":null}]}],"displaySeparator":true,"description":null}]},{"type":"intro","toolbar":null,"title":null,"pageName":"wba_OnlineApplicationRegisterConfirm","messagePropertyId":"vw_registerConfirm","form_groups":[{"type":null,"title":null,"referenceTo":"87b35a65-c65b-4d8d-b286-dd721bef05dc","messagePropertyId":"vw_sec_registration_confirmation","isTemplate":null,"form_field_sets":[{"type":"standard","referenceTo":"2c7e3d90-73aa-4887-a3bd-c89ac1cb866f","messagePropertyId":null,"form_fields_store":null,"form_fields":[{"values":null,"value":"<p><span style=\"color:rgb(120, 162, 47); font-family:lucida grande,lucida sans tahoma,arial,sans-serif; font-size:small\">An e-mail has been sent to: {{Online_Grant_Application__c.Registration_Email__c}}.</span><br />\nYou have been sent an e-mail that contains instructions on what to do next to begin the application process. 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