Hidden fields






The form will automatically be displayed in English. To change what language the form questions show in, please select an option from the dropdown. 
You've been referred to Little Village but we have been asked to get more detail from you about what you require as your referrer was unsure. Please press next and fill in details
Refer a family to Little Village

Thank you for your interest in referring a family to Little Village. We provide clothes and equipment for babies and children up to the age of 5. Please make sure you explain to the family how Little Village works before making the referral. Unless there is information we need to clarify, we will not contact the family directly before delivering their bundle. Depending on which borough the family live in they may be eligible to visit one of our sites to choose their items. Please make sure the information on th​e form is accurate.

We are only able to provide clothing and kit for families who live in these boroughs. 
Unfortunately, we can't support the family at this time because they live outside our core boroughs. You can find links to other baby banks and other resources which may be useful on our website 
 

We will support the family through their existing referral and are unable to take a second referral for them at this time. Please reassure the family that we will be in touch regarding their original referral.
Your Details












Please enter in numbers with no spaces

Please enter in numbers with no spaces
Family Details
Thanks for providing all your information. Now we need some details about the person you're referring.




Address Information

Please ensure address is complete as we will not be able to deliver otherwise!






PLEASE ENTER NUMBERS ONLY - DO NOT LEAVE ANY SPACES

We cannot deliver to families without an accurate phone number.


Referral Details


Please tell us how many people live in same household under categories below:
Please check over the address and contact details to make sure this is correct. 



(Please note, we cannot deliver items to you without a phone number. Please ensure this number is up to date and all digits are included - thanks!)
Additional Family Information















The next section will be about the items the family needs.  Please answer every question as accurately as possible. We will pack and deliver the bundle directly to the family's house based on the details you provide and will not be able to call the family to check on anything.  If we have incomplete information eg. clothes or nappy size or addresses with insufficient detail, this may cause a delay and/or make us unable to deliver.






   
The next section will be about the items the family needs.  Please answer every question as accurately as possible. We will pack and deliver the bundle directly to the family's house based on the details you provide and will not be able to call the family to check on anything.  If we have incomplete information eg. clothes or nappy size or addresses with insufficient detail, this may cause a delay and/or make us unable to deliver.
Child Details
Please complete this section for one child. If there are other children (including twins or triplets) up to the age of 5 who need items, you will have an opportunity to add another child after you have selected the items for the first child. 



Items needed 

Most of the items we offer are donated and so we can only gift out what we have received from the public.  Because of this, we may not have all items available and during busy periods may need to limit what we can offer. 

Please make sure the family are aware that the majority of the items we send will be second hand. We make sure they are in great condition and quality, clean and fit for use.   

Please let us know what items are needed for this child by checking the relevant boxes and then selecting from the list below. If the child doesn’t need this item, please don’t check the box.  
Items needed 

Most of the items we offer are donated and so we can only gift out what we have received from the public.  Because of this, we may not have all items available and during busy periods may need to limit what we can offer. 

Please be aware that the majority of the items we send will be second hand. We make sure they are in great condition and quality, clean and fit for use.   

Please let us know what items are needed for this child by checking the relevant boxes and then selecting from the list below. If the child doesn’t need this item, please don’t check the box.  

If there are other children (including twins or triplets) up to the age of 5 who need items, please select “Add another child” at the bottom of the page after you have entered the items for the first child.


























Please note that availability of travel equipment is dependent on donations & requirements



As you have chosen 'baby bath' and 'bath support', we will send only one of these items depending on availability.



We’ll send a microwave steriliser if we can.
As you have chosen 'Hair Chair' and 'Travel High Chair', we will send only one of these items depending on availability.



IF THERE ARE OTHER CHILDREN (INCLUDING TWINS OR TRIPLETS) UP TO THE AGE OF 5 WHO NEED ITEMS, PLEASE SELECT +Add another child HERE:


Please double check that you have entered requests for all children who are part of this multiple birth by clicking on +Add another child above.

Thank you for listing the family's needs - that is extremely helpful. Because of their location, this family is eligible to book an appointment to choose specific items at one of our sites. Please note, everything apart from large kit, such as beds and buggies, will have to be transported home by the family. We can arrange for large kit to be delivered.



Nearly finished!
Thank you very much for making this referral to Little Village. We will pack the family’s items as soon as we can and confirm the delivery date with them directly. We aim to respond within 4-6 weeks.  
Thank you very much for making this referral to Little Village. We will direct you to an appointment booking page in a moment so that you can choose a time/date for the family to visit a local Little Village site.
Thank you very much for making this referral to Little Village. We will send the person you are referring a link to an appointment booking page in a moment so that they can choose a date/time to visit a local Little Village site.

Please confirm if you are happy for us to keep you informed of Little Village’s news, fundraising efforts or about taking part in user surveys and events, by:
Thank you very much for letting us know about the items you’d like from Little Village. We will pack your items as soon as we can and confirm the delivery date with you directly. We will aim to complete your referral within 4-6 weeks. 

Please confirm if you are happy for us to keep you informed of Little Village’s news, fundraising efforts or about taking part in user surveys and events, by: