BDA Benevolent Fund - Dentists Application Form

Application Submitted As

The BDA Benevolent Fund supports dental students, dentists, and their families.

Please note: we will be closed from 18 December 2025 to 5 January 2026 and will not be considering applications during this time.

Financial Support

To access financial assistance, you must belong to one of the following categories:

Undergraduate dental student: You are currently enrolled in a BDS/BChD course (and have already started your studies).
Current or former dentist: You are, or have been, registered with the General Dental Council (GDC) as a dentist.
Asylum seeker or refugee: You are a current or former dentist (through registration, qualification, or equivalent) and hold asylum seeker or refugee status.
Dependent of a dentist: You are the spouse, partner, widow/widower, or someone responsible for the child(ren) of a dentist.

You must currently be living in the UK.

Financial aid is available to individuals who cannot meet their current personal expenses due to insufficient income from work, state support, student finance, or savings. Applicants with funds in their account exceeding £10,000 will not be considered are expected to use their own monies before applying (with the exception of funds set aside for tax).

The Charity operates independently of the British Dental Association (BDA). Membership with the BDA is not required to request assistance.

Wellbeing Support

Wellbeing support is available anonymously, for free, and at any time—no application form is necessary.

Visit our website to learn more: https://www.bdabenevolentfund.org.uk/wellbeing/, or download the Wellbeing Support for the Dental Team resource here: https://www.supportfordentalteams.org/.

If you have any questions, please contact us:

Email: info@bdabenevolentfund.org.uk
Phone: 0207 486 4994
(Office hours: Monday–Friday, 9:30 am–5:30 pm, excluding public holidays)

This form can be saved as you go along and resumed later. Once complete, please check the content for its accuracy and then press 'submit'. You will receive an automated notification that it has been sent to us. Please note, fields with a * are mandatory. The form cannot be processed without this information.

Personal details

Title

Other (Please specify title)

First Name

Last Name

Email Address

Date of Birth

Please use the correct format with forward slashes.

Contact Number

Address

Town/City

County

Post Code

Other information

General Dental Council (GDC) Registration Number

If you are no longer registered with the GDC, please upload evidence of your prior registration at the end of the application.

What year did you qualify as a dentist?

I identify my gender as

Other (Please specify gender)

Your household

Do you have a partner?

Marital Status

Spouse/Partners Occupation

Do you live with anyone?

YesNo

How many people?

Person relationship to you

Age

Is this person dependent on your income?

How many people?

Is anyone else dependent on your income that does not live with you?

YesNo

Relationship to you

Age

Employment

Current employment (if applicable)

Current role title

Address

Date you started

Previous employment - please provide details of last 2 years of your employment history

Previous role title

Address

Start and finish dates

Financial information - assets

Do you live in rented accommodation?

YesNo

Do you /your partner own any property? This includes any mortgages

YesNoPlease tick yes if you have a mortgage, part or shared ownership etc.

Date of purchase

Property cost

£

Current value

£

Outstanding mortgage*

£

* If applicable

Years left to pay

* If applicable

Do you or your partner own any vehicles? This includes cars bought using finance i.e. hire purchase

YesNoIncluding hire purchase or conditional sale vehicles

Date of purchase

Vehicle cost

£

Current value

£

Outstanding amount left to pay*

£

* If applicable

Years left to pay*

* If applicable

Assets (money in credit)

	Total Amount - You	Total Amount - Partner
Current account	£	£	1 Add another
Current account 2	£	£	2 Add another
Current account 3	£	£	3 Add another
Current account 4	£	£
	£	£	£

For us to consider your request through this form, you must provide bank statements for all your accounts covering the last three months from the date of your application.

If you are living with a partner, their bank statements must also be included. These statements are used to verify the information you have provided.

Supporting evidence

Important Requirements:

File format: The statements must be submitted as a PDF file. We cannot accept Excel files, photos, or screenshots.

Details included: The statements must clearly show your full name and address (transaction summaries are not accepted for this reason).

How to Download Statements:

If you’re unsure how to download your bank statements, search online for instructions by typing your bank’s name followed by “download bank statements.”

Note: If you do not provide the required documents in the correct format your application form cannot be considered. The number of statements provided should reflect the details provided on the application form.

Debts/ liabilities (money owed)

Detail all the information regarding the money that you owe, giving the total amount owed, and how much you are paying this back e.g. monthly or annually. This helps to give a full picture of your financial situation and also should be reflected in the information you provide on the next few pages.

	Overall outstanding amount	Monthly Payment -You	Monthly Payment-Partner
Current Account Overdraft	£	£	£
Other Account Overdraft	£	£	£
Loan	£	£	£
Loan	£	£	£
Hire Purchase	£	£	£
Credit Card	£	£	£	1 Add another
Credit Card 2	£	£	£	2 Add another
Credit Card 3	£	£	£	3 Add another
Credit Card 4	£	£	£	4 Add another
Credit Card 5	£	£	£	5 Add another
Credit Card 6	£	£	£
Store Card	£	£	£
HMRC	£	£	£
Family/Friends	£	£	£
Rent/Mortgage Arrears	£	£	£
Utility Arrears	£	£	£
Other	£	£	£
	£	£	£

Monthly income

	You	Partner
Salary/ wages i.e. earned income from working	£	£
Practice drawings	£	£
State pension	£	£
Bereavement allowance	£	£
Private pension(s)	£	£
Pension credit	£	£
Employment Support Allowance (ESA)	£	£
Housing Benefit	£	£
Working Tax Credit	£	£
Maternity Pay/Maternity Allowance	£	£
Paternity Allowance	£	£
Support for Mortgage Interest	£	£
Council Tax Reduction/Support or Rate Relief	£	£
Incapacity Benefit	£	£
Disability Living Allowance (DLA)	£	£
Personal Independent Payment (PIP)	£	£
Universal Credit (UC)	£	£
Carers Allowance	£	£
Attendance Allowance	£	£
Child Benefit	£	£
Child Tax Credit	£	£
Contributions towards Children	£	£
Other Benefits Total (Please list which ones below)	£	£
NHS Pension	£	£
Payments from charities	£	£
Other Income Total (Please list more detail below)	£	£
	£	£

Other Benefits

Other Income

Monthly expenditure

	You	Partner
Rent	£	£
Mortgage	£	£
Secured Loan	£	£
Mortgage Endowment	£	£
Service Charge/Ground Rent	£	£
Water	£	£
Council Tax	£ Including water charge if you live in Scotland and rates in NI	£ Including water charge if you live in Scotland and rates in NI
Gas	£	£
Electricity	£	£
Other Household Fuels	£	£
Telephone and Internet	£	£
Mobile	£	£
TV Licence	£	£
Other Television Bills	£	£
Buildings/Contents Insurance	£	£
Life Insurance	£	£
Childcare	£	£
Child Maintenance or Child Support	£	£
BDA or other professional membership	£	£
Car Insurance	£	£
Road Tax	£	£
MOT and Ongoing Maintenance	£	£
Petrol	£	£
Public Transport	£	£
Food and Housekeeping	£	£
Pets and Pet Insurance	£	£
Medicine/Prescriptions	£	£
Professional Fees	£	£
Indemnity	£	£
Loan Repayments	£	£
HP Repayments	£	£
Credit Card Repayments	£	£
Other Essential Living Costs (Combined Total)*	£	£
Furniture and Appliance Rental	£	£
Hobbies, Leisure or Sport	£	£
Total	£	£

*Please list what your other (essential) living costs are, if applicable

What assistance are you seeking and how can we help you?

We deal with all requests on an individual basis as no two situations are the same. We aim to tailor our grants to best match your immediate needs. We support those that are currently facing financial hardship in accordance with out Grantmaking Policy. Financial hardship is defined as having insufficient income and/ or savings to manage your current essential living costs. Please watch our guidance notes video prior to applying to see who and how we help.

Tick the relevant category/categories below and fill out the sections that are applicable to you and provide us with a summary of your current circumstances, specifically how this has led to you approaching us for financial assistance.

Difficulties due to physical or mental ill health including addiction

Further details of physical or mental health

Difficulties within your relationship or with your family

Further details of relationship difficulties

Difficulties at work e.g. with your employer, the GDC, NHS England or because of unemployment

Further details of work difficulties

Difficulties with money including unexpected expenditure, debts or problems with cash flow

Further details of financial difficulties

Other

Further details of any other difficulties

What do you feel that the BDA Benevolent Fund can do to assist you with the above? If you haven't already, please watch the guidance video to understand how we help.

Please be as specific as possible about what support you would benefit from based on the difficulties outlined above

Please provide a detailed response (minimum 500 characters and maximum 2000 characters) explaining the type of support you are seeking and how the BDA Benevolent Fund can assist you.

Signposting

Have you applied to any other charities?

YesNo

Please detail the name of the person/organisation/ charity, the date(s) you contacted them and the support you were offered.

Have you sought advice from any other professional person/ organisation/ charity?

YesNo

Please detail the name of the charity, the date(s) you applied and the support you have been offered (if applicable)

Permissions and declarations

The BDA Benevolent Fund is committed to safeguarding your privacy and will take every precaution to ensure your information is handled in line with data protection law. Your information will remain confidential and used only to assess your application, except where we are legally or professionally required to share it (for example with regulators, your university, Action Fraud, or the police). Please note, Artificial Intelligence (AI) may be used in the processing of your application.

Declarations

By ticking the box, I confirm that:

The information I have provided in this form, and any supporting documents, is accurate and honest. This is in line with Principle 1.3 of the GDC’s Standards for the Dental Team, which requires registrants to act with integrity and not sign documents that are false or misleading.

I understand that providing false, misleading or dishonest information will result in my application being refused or withdrawn, and may be reported to the General Dental Council, your university (if applicable), Action Fraud, and the police.

I will notify the BDA Benevolent Fund of any change in my circumstances during this process.

I consent to my personal data being processed and stored by the BDA Benevolent Fund to administer my application. This may include special category data (such as health information), which will be processed under the UK GDPR where necessary and with my explicit consent.

My form and supporting information will be kept in line with the BDA Benevolent Fund’s retention policy, available on the website or from the office.

Residency

The country in the world I am resident of (for tax purposes) is

UKOther

Please state the country/ies if other:

To help us please confirm the following

What is the main reason for your application?

Other (Please specify)

How did you hear about our services?

Other (Please specify)

Please click the submit button for your application to be processed.

On the next page you will then be given the opportunity to review and edit the information in your form for a final time prior to submission. It is at this stage you are also given the option to print the form for your records, should you wish to do so. Alternatively, if you do not have access to a printer, you can save the information as a web page by right clicking 'save as' and saving it to your device (ideally as a PDF).

We aim to acknowledge all applications within 3 working days.

If relevant, we will arrange a call to learn more about your situation, to go through any queries and to explain our process.