REFERRAL | Jade's Bag Charity

Submit a Referral

Jade's Bag Charity will endeavour to help those in current crisis.

We aim to reply to all requests within 48 hours to inform you on whether your request is successful or not. If you do not receive an answer in the specified time, then please contact us using the details at the bottom of this page.

For Christmas Dinner Bags please click here. For standard referrals please complete the form below.

Full Name

Referral Phone Number

Referral Recipient Name

Referral Email Address

Referral Recipient Home Address

Referral Recipient Postcode

Referral Recipient Phone Number

The Circumstances

Please include the recipient’s current circumstances, e.g. fled domestic violence, lack of finances to cover living costs, etc.

The Requirement

Please include the recipients requirements e.g Food, Clothing etc.

Are there any children?

Yes

If yes, how many?

If yes, what are their ages?

Select the items that are required for this referral:

Please leave blank where item(s) are not required

Other:

Other

Do you have any dietary requirements?

Please Note

We will do our best to provide the items listed in this referral, including the choices selected. However, all support is subject to availability. If an item is not available, we may provide a suitable alternative unless you have clearly stated otherwise in the requirements field.

If the recipient requires a vegan, vegetarian, halal or gluten-free parcel, please select the items that are suitable and provide any additional dietary requirements in the requirements field.

Terms and Conditions

By submitting this referral, you confirm that the information provided is accurate to the best of your knowledge and that you agree to Jade’s Bag Charity’s referral terms and conditions.

Due to the number of requests we receive, successful applicants are not eligible to re-apply for further assistance for the following 12 months.

Jade’s Bag Charity provides support with emergency grocery shopping, selected school uniform items, children’s beds, and essential family items such as toiletries, children’s clothing, baby essentials and blankets.

We are unable to provide money, vouchers, alcohol or tobacco

Single choice

I agree to the terms & conditions

Submit a Referral

Select the items that are required for this referral: ​

Select the items that are required for this referral: