Disabled Holiday Trust Application Form	
CONFIDENTIAL when completed
 
Section 1 – RAF Service Details
Please provide details of RAF/Ex-RAF Person. (Service Details will be confirmed with RAF Records office)

Surname	  Mr/Mrs/Miss	
Forename(s)	 	
Address		
Town/County		
Post Code		
Contact Number		
Email Address		
Date of Birth		
Rank		
Service Number		
Dates of Service	  From: -                                                           To: -	
Was service Regular, War Service or National Service?		

Section 2- Details of the Disabled Person (if different from above*)
*Surname	  Mr/Mrs/Miss	
*Forename(s)	 	
*Date of Birth		
*Relationship of disabled person to person above (if different)		
		
No of dependent children		
Please state nature of disability	

	
What effect does disability have on mobility?	

	
If they use a wheelchair, how often do they use it?	

Any other information that you would like to share.	

	

Section 2 – Eligibility
Is the qualifying person one or more of the following? Tick the one that applies
 	
Registered blind. 	 	
Receives the higher rate of DLA/PIP Mobility. 	 	
Receives War Pensioners’ Mobility Supplement. 	 	
On-going Guaranteed Income Payment (and necessarily an earlier Armed Forces Compensation Scheme payment) for having a permanent disability causing an inability or significant difficulty in walking. 	 	
Attendance Allowance	 	
None of the above.

Section 3 – Benefits

Is the qualifying person/household in receipt of any of the below means tested benefits? (Tick any that apply)
These will be evidenced by 3 months of bank statements or entitlement letter (less than 3 months old) in line with the Funds welfare policy.

Pension Credit. 	 	
Universal Credit. 	 	
Income Support. 	 	
Income Related Employment & Support Allowance.	 	
Income Based Jobseekers Allowance.	 	
Housing Benefit.	 	
Working and Child Tax Credits.	 	
None of the above. 	 	

Section 4 – How did you hear about the trust (Please tick any which apply)

Word of mouth. 	 	
War Pensions agency. 	 	
Royal Air force on discharge. 	 	
SSAFA, Forces Help.	 	
RAF Benevolent Fund or RAFA	 	
Family or friends	 	
Online search	 	
Other, please specify.	 	
	
Section 5 –Data Protection and Declaration
Data Protection:
The RAF Benevolent Fund Disabled Holiday Trust is committed to ensuring that we handle all data which we hold about you, in a safe, secure, and responsible manner and in accordance with the UK General Data Protection Regulation (UK GDPR) and Data Protection Act 2018.

The personal data submitted on this form will be used for the following purposes:

•	Assessing your application for a Disabled Holiday Trust break.
•	Evaluating the Disabled Holiday Trust and the impact it has.
•	To progress your application, we may need to share some data with:
-	Holiday Property Bond Company, the holiday provider for the RAF Benevolent Fund Disabled Holiday Trust.
-	Our Medical Advisor

Please tick this box if you agree to the RAF Benevolent Fund processing your personal data, including special category data, for the purpose of assessing this application for a DHT holiday. Any data that you record via this form will be held on file to contact you for future holidays.
I agree
For further information on how the RAF Benevolent Fund manages your data and your rights please visit www.rafbf.org/privacy which tells you how we will use, manage and store the personal data you have submitted in relation to this application.

Declaration:
I agree that:
•	all the information provided in the application form is true and correct.
•	I will inform the RAF Benevolent Fund Disabled Holiday Trust of any change in my circumstances during and after the application process.
•	the RAF Benevolent Fund reserves the right to undertake basic checks to confirm the veracity of the information provided.
•	everyone whose details are included on this form have read, understood, and agreed to the above declarations.
•	the RAF Benevolent Fund can share necessary details from my application with property booking company.
I agree
Applicants Name		
Date