Reach Membership Bursary application form

Information about you

Everyone should fill in this section of the form. Please note that in 2025 the Membership Bursary form is for Reach Families and living in the UK, Ireland, Isle of Man or Channel Islands).

Is this for a:

Family Membership Bursary (please go to section one)Individual membership Bursary (Please go to section two)

ALL QUESTIONS IN YOUR SECTION MUST BE ANSWERED

Section One - Family Membership

Parent/carer's/your full name

Parent/carer's/your full postal address

Parent/carer's email address

Phone number

Is your Reach child aged 0-17 and living in the UK, Ireland, Isle of Man or Channel Islands

YesNo

Details of your Reach Child/Young person/Reach Adult the application is for

1.Childs Name?

Date of birth?

Nature of upper limb difference?

Nature of any other relevant disabilities or long-term health conditions

Section two - Individual membership

ALL QUESTIONS IN YOUR SECTION MUST BE ANSWERED

I am a Reach Adult

Yes

Date of Birth

Your email address

Full postal address?

Nature of upper limb difference?

Nature of any other relevant disabilities or long-term health conditions

Previous Bursary History

Everyone to complete this section

Have you/your family received an award from a Reach Bursary Scheme in the past five years?

YesNo

Please provide details of your previous Reach Bursary Award. Please note that the Reach Bursary Scheme is limited to one application per year per individual; and a maximum of three awards, or awards totalling £5,000, in any five year period.

CONSENT

Data protection law requires that we have your consent to process your data - in this case, this means to consider your application and make any award. We also need to account for the awards in our Annual Report, though this can be done anonymously. If you do not consent, we are unable to consider your application. Our usual practice is to retain bursary applications for five years after an award is made - this is because there are restrictions on the number of times people can apply for bursary awards and the overall total of awards they can receive in a period of five years. Our privacy policy are available on our website.

I consent to Reach processing my personal data for the purposes of considering my application for a Reach Bursary award.

YesNo, and I understand this means that my application cannot be considered.

Contact Information