In order to process your referral we ask for your personal details and information about your immigration history. The information provided on this form will remain confidential and will not be shared outside of Kids in Need of Defence UK organisations and partners (including pro bono partners) without your permission.
Some of the information is required in order for us to deal with your referral. There is a star next to these questions. Some of the information is helpful to us so that we can understand who needs our help and we can use it to support funding applications or to campaign on important issues but you do not have to provide it.
If you are providing this information on behalf of someone else, you must make sure that you have their permission to share that information with us.
If you are completing this form on behalf of someone else, please answer the questions as though you are the child or young person who wishes to make an application.
If you wish for your immediate family members to be included in the application please provide their details below.
If you have any family members living in your country of origin please provide the following information
If you have answered yes to any of the questions above please provide the details of the current or previous lawyer(s) involved in your case
Please provide details of any schools that you/your children have attended
Please provide the name, phone number and surgery address of your GP (if different family members have different GPs provide details of each GP)
Do you, or any of your family members, have any health problems, illnesses or medical conditions?
If you, or any of your family members, have spent time in local authority care please provide details: