BDA Benevolent Fund - Dependent Application Form

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


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:


This form can be saved as you complete it and resumed at a later time.

Before submitting, please review all information carefully to ensure it is accurate. Inaccurate information (whether provided intentionally or unintentionally) may result in delays or a decision not to offer financial assistance.

Once submitted, you will receive an automated confirmation that your application has been received. Please note that all fields marked with an * are mandatory; applications missing this information cannot be processed.

Applicant details











Other Information



If the person you are dependent upon is no longer registered as a dentist with the GDC, please provide some evidence e.g. a registration certificate. This is to demonstrate that they were a dentist so we can verify you are eligible to access financial assistance.

We will also need evidence you are or were dependent on that person. This can be a marriage certificate or a birth certificate for your children.
Supporting Evidence

Important Requirements:


File format: The document must a PDF file. We cannot accept Excel files, photos, or screenshots. 


Note: If you do not provide the required documents in the correct format your application form cannot be considered. Please contact us on 0207 4864994 or info@bdabenevolentfund.org.uk if you have any queries. 

Your Household












Employment




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



Financial Information - Assets



£


£ 

£ 
* If applicable

* If applicable

Including hire purchase or conditional sale vehicles

£


£

£
* If applicable

* If applicable
Assets (money in credit)
Total Amount - You Total Amount - Partner  Monthly Payment - Partner
Current Account
£ 
£
Current Account
£
£
Current Account
£ 
£
Current Account
£
£ 

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

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.  The files should be original, not annotated. 

Details included
: The statements must clearly show your full name and address (transaction summaries or screenshots 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 processed. The number of statements uploaded should reflect the details you have provided on this form i.e. if you have three current/ savings accounts, then you need to upload nine files.

Financial Information - Debts
Debts/Liabilities (money owed)
 Overall outstanding       amount Monthly Payment             - You Monthly Payment                   - Partner
Current account overdraft
£ 
£ 
£ 
Other account overdraft
£ 
£ 
£ 
Bank Loan
£ 
£ 
£ 
Bank Loan
£ 
£ 
£ 
Hire purchase
£ 
£ 
£ 
Credit card
£ 
£ 
£ 
Credit card 2
£ 
£ 
£ 
Credit card 3
£ 
£ 
£ 
Credit card 4
£ 
£ 
£ 
Credit card 5
£ 
£ 
£ 
Credit card 6
£ 
£ 
£ 
Store card
£ 
£ 
£ 
HMRC
£ 
£ 
£ 
Family/friends
£ 
£ 
£ 
Rent/Mortgage arrears
£ 
£ 
£ 
Utility arrears
£ 
£ 
£ 
Other
£ 
£ 
£ 

£ 
£ 
£ 
Current Monthly Income
You  Partner 
Salary 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 (Please list which ones below)
£ 
£ 
NHS Pension
£ 
£ 
Payments from charities
£ 
£ 
Other income (Please list more detail below)
£ 
£ 
£ 
£ 


Current 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
£ 
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 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                                TOTAL AMOUNT *
£ 
£ 
Furniture and Appliance Rental
£ 
£ 
Hobbies, Leisure or Sport
£ 
£ 
Food and Housekeeping
£ 
e.g. food, drinks, cleaning, school meals, meals at work, laundry and toiletries
£ 

£ 
£ 

What assistance are you seeking and why?







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




Permissions and declarations
The BDA Benevolent Fund is committed to safeguarding your privacy and handles all personal information in accordance with applicable data protection legislation, including the UK GDPR and the Data Protection Act 2018. Your information will be kept confidential and used only for the purpose of assessing and administering your application, except where disclosure is required by law or professional obligation (for example to regulators, your university, Report Fraud, or the police). Artificial Intelligence (AI) tools may be used as part of our application processing procedures.

For further information about how we collect, use, retain and protect your information, including personal data, please refer to our privacy information, which is available on the website or on request.


Declarations
  1. The information provided in this form, together with any supporting documents, is accurate and truthful. This reflects Principle 1.3 of the General Dental Council’s Standards for the Dental Team, which requires registrants to act with integrity and not sign documents that are false or misleading or provide information that is dishonest. I understand that providing false, misleading, or incomplete information, including deliberately withholding relevant details or failing to supply requested documents (such as bank statements), may be considered dishonest and may result in my application being refused or withdrawn.

  2. Fraudulent applications may be reported to the General Dental Council, your university (for dental students) to the police and/ or other relevant authorities or regulators.

  3. I will notify the BDA Benevolent Fund of any changes in my circumstances during the application process.

  4. I understand that the BDA Benevolent Fund will process my personal data as necessary for assessing and administering my application. This includes processing based on legitimate interests, contractual obligations or other appropriate lawful bases under the UK GDPR, depending on the nature of the data and the processing activity.

  5. Where I choose to provide special category personal data (such as health information), I give my explicit consent for the BDA Benevolent Fund to process that information for the purposes of assessing and administering my application. I understand that I may withdraw this consent at any time, although this may affect the Charity’s ability to consider my application.
Residency


To help us please confirm the following




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.