BDA Benevolent Fund - Dental Student Application Form

Application Submitted As

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.

You should first apply to (and had the outcome of) your university's hardship/ financial support fund before submitting this form. Your application will not considered if you haven't completed this step.

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 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

Title

Other (Please specify title)

First Name

Last Name

Email Address

Current Address i.e. Term Time

Town/City

County

Post Code

Contact Number

Date of Birth

I identify my gender as

Other (Please specify gender)

University Details

University Name

Course Name

Year of Course

Are you a?

Is this your first degree?

Have you sought assistance from your University's Hardship Fund?

YesNoAll dental student applicants should apply to (and have the outcome) their university's hardship fund before applying to us. If you have not done this, your application cannot be processed. If you have any queries, please contact the office on 0207 4864994.

If yes, please indicate when

Please enter a date after 1st September 2025

How much were you given?

Supporting Evidence

Please upload your most recent Student Finance letter (from England, Wales, Northern Ireland, or Scotland) for the current academic year. This will help us verify your student status and income. If you are an international student, please upload a matriculation letter or equivalent document.

In addition, all students must upload a current Certificate of Status confirming your enrolment. This should be a PDF and be dated within 2 weeks of your application. Please note that we cannot accept photographs.

⚠️ Important Information

All dental student applicants must have already applied to and received the outcome of their university’s hardship or financial support fund before applying to the BDA Benevolent Fund.

If you have not done this, your application cannot be considered and you will not be able to proceed further.

You may click Previous Page to review your information or check your eligibility.

If you have any queries, please contact the office on 0207 486 4994.

Current Living Situation

Do you have a partner?

Marital Status

Spouse/Partners Occupation

Do you live with anyone in your household?

YesNo

How many people?

Person relationship to you

Age

Is this person dependent on your income

Is anyone else dependent on your income but does not live with you? A dependent is a child, or a partner/ spouse.

YesNo

How many people?

Relationship to you

Age

Current employment

Are you currently working?

YesNo

Current Job title

Address

Date of Employment

Previous Employment (if applicable)
- please provide details of last 2 years employment history

Previous Job Title

Address

Dates of Employment

Financial Information

Do you live in rented accommodation?

YesNo

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

YesNo

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 Original 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	Monthly Payment - Partner
Current Account	£	£	1 Add another
Current Account 2	£	£	2 Add another
Current Account 3	£	£	3 Add another
Current Account 4	£	£
	£	£	£

Supporting Evidence

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.

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.

Debts/ liabilities (money owed)

Please detail all the information regarding the money that you owe, giving the total amount owed (the outstanding balance), and how much you are paying this back on a monthly or annual basis. If you aren't paying it back, leave the monthly section blank. Do not include your student loan unless this was taken out as a bank loan.

	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	£	£	£
	£	£	£

Annual Income (from 1 September - 31 August i.e. this current academic year)

Please take the time to go through this and do not guess this information. We suggest you refer back to your bank statements in order to provide you an accurate picture of your finances. Any discrepancies will be discussed and will delay your request being processed and may affect the decision made. This must be filled out after September for the academic year. We do not consider requests in advance of the next academic year.

	You	Partner
Earned income from working	£	£
Tax credits	£	£
Disability Living Allowance (DLA)	£	£
Personal Independent Payment (PIP)	£	£
Child Benefit	£	£
Child Tax Credit	£	£
Contributions towards Children	£	£
Financial Contribution from Family (i.e. Parents/ Partner/ Grandparents)	£	£
Housing Benefit	£	£
Carer's Allowance	£	£
Other Benefits Total (Please list which ones below)	£	£
Student Loan	£	£
NHS Bursary	£	£
University Hardship	£	£
Payments from Charities	£	£
Other Income Total (Please list more detail below)	£	£
Bursary	£	£
Scholarship	£	£
	£	£

Other Benefits

Other Income

Annual Expenditure (from 1 September - 31 August i.e. this current academic year)

Please take the time to go through this and do not guess this information. We suggest you refer back to your bank statements in order to provide you an accurate picture of your finances. Any discrepancies will be discussed and will delay your request being processed and may affect the decision made. This must be filled out after September for the academic year. We do not consider requests in advance of the next academic year.

	You	Partner
Rent/ mortgage	£	£
Water	£	£
Gas	£	£
Electricity	£	£
Other Household Fuels	£	£
Telephone and Internet	£	£
Mobile	£	£
TV Licence	£	£
Other Television Bills	£	£
Buildings/Contents Insurance	£	£
Childcare	£	£
Child Maintenance or Child Support	£	£
BDA Membership	£	£
Car Insurance	£	£
Road Tax	£	£
MOT and Ongoing Maintenance	£	£
Petrol	£	£
Public Transport	£	£
Food and Housekeeping	£	£
Medicine/Prescriptions	£	£
Course Fees	£	£
Indemnity	£	£
Bank loan Repayments	£	£
Car Finance/ Hire Purchase Repayments	£	£
Credit Card Repayments	£	£
Other Essential Living Costs (Combined Total)*	£	£
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 personal relationships or with your family

Further details of relationship difficulties

Difficulties while at university

Further details of university difficulties

Difficulties at work e.g. with your employer 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 provide a detailed response (minimum 500 characters and maximum 2000 characters) in full sentences explaining the type of support you are seeking and how the BDA Benevolent Fund can assist you so that we understand why you are applying for help. Insufficient information may cause your application to be delayed or refused.

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

Have you sought advice from any other professional person or organisation?

YesNo

Please detail the name of the person/organisation, the date(s) you contacted them 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, or Report Fraud). Please note, Artificial Intelligence (AI) may be used in the processing of your application.

Declarations

By ticking the box, I confirm that I have read and understood the following:

The information I have provided in this form, and any supporting documents, is accurate and truthful. 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 to 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 provide requested supporting documents (such as bank statements) may be considered dishonest and may result in my application being refused or withdrawn.

Fraudulent applications may be reported to the university, and to the police or other appropriate authorities.

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

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

My form and supporting information will be retained in line with the BDA Benevolent Fund’s retention policy, which is available on the website or on request 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.