Help Request

If you need help, please complete the online form below. The form and its details are submitted to Variety - the Children's Charity of Jersey, Maufant Variety Youth Centre, La Grande Route de St Martin, St Saviour, Jersey, JE2 7GT.

Alternatively email admin@varietyjersey.org.je or call the Variety Office on 01534 856937.

All requests are dealt with in the strictest confidence.  

Please complete the form below in full and click submit or download the printable version, complete and return it to the Variety Office.

1st Parent / Guardian Name *
1st Parent / Guardian Name
Date of birth of 1st Parent / Guardian *
Date of birth of 1st Parent / Guardian
2nd Parent / Guardian Name (If Applicable)
2nd Parent / Guardian Name (If Applicable)
Date of Birth of 2nd Parent / Guardian (If Applicable)
Date of Birth of 2nd Parent / Guardian (If Applicable)
Address *
Address
Please list all your children's names and dates of birth.
(You and Partner)
£
(To include any other Benefits received from Social Security)
£
£
£
£
£
*
Is this Weekly Mortgage / Rent paid by:
(After Mortgage / Rent Deducted)
£
Reason for needing help *
Please tick as appropriate
NB - False declarations may result in immediate rejection of your Claim
£
We collect, hold and in limited circumstances share your personal data in accordance with our Privacy Notice which can be accessed below. The information collected on this application form is subject to the Data Protection (Jersey) Law 2005 and is used for the purpose of assessing suitability for Variety assistance. It will not be used or disclosed for any other purpose without your consent. By clicking Submit, I hereby confirm that to the best of my knowledge the information I have provided is correct and I give my consent to Variety - the Children’s Charity of Jersey to check any relevant details with Social Security and any other Agency as may be required.