Panel Member (If applicable) 
Date of Panel or Date Submitted   

Social Worker Name and Social Work Centre    School   

Child’s Initials/ Swift Number  (Full name and DOB can only be used after GDPR form has been signed) 

Grant Amount  £      
Purpose of Grant           

Benefits to the Child    

Brief Background (Why they are involved in the hearing system and need a grant from Kilbrandon Fund) 


Please note that for audit compliance, once a grant has been approved and payment made, a follow-up email will be sent to the agency requesting the grant for confirmation that the purpose of the grant had been achieved.   This will usually be within 6 weeks of the bank transfer.