Change of Principal or Secondary Fund Advisor

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Fund Details

Are you requesting a change of principal fund advisor or secondary fund advisor?

Please enter details of your designated fund below. If you're not sure of the name or number of your designated fund, please click here to see a full list.

Designated Fund Name

Designated Fund Number

New Fund Advisor Details

Title

First Name of New Fund Advisor

Surname of New Fund Advisor

Job Title

Department, Ward or Area

Care Group

KCH site where you are primarily based:

Please provide the name of the site you are applying from

Organisation

Please provide the name of the organisation you are applying from

Work Phone

Work Email

Declaration

I am a senior employee of (or have an honorary contract with) King’s College Hospital NHS Foundation Trust. I have read the Charity’s Operating Instructions for Designated Funds and agree to operate this fund in accordance with those instructions.

I confirm the above statement

I have read and understood the Charity’s Data Privacy Statement regarding use of the above personal data and confirm I agree to this use of personal data.

I confirm the above statement

Date

Trust Approval

We require all fund advisor changes to be supported by the relevant management approvals. The person named below will be emailed a copy of this form and asked to confirm their authorisation for it through an online process. Please ensure you provide accurate details and you may like to inform them about this process as the Charity will not be able to process your application without these authorisations.

Title Deputy/Director of Operation, General Manager or equivalent Senior Trust Staff Member

First Name Deputy/Director of Operation, General Manager or equivalent Senior Trust Staff Member

Surname Deputy/Director of Operation, General Manager or equivalent Senior Trust Staff Member

Job Title Deputy/Director of Operation, General Manager or equivalent Senior Trust Staff Member

Email Work

IMPORTANT: In the next screen you will be able to save a PDF copy of your application by clicking Print this page and from the Destination drop down select Save as PDF.

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