Learning and Development Request for Support Form

Our funds are limited, so we may not be able to provide help for all the requests we receive for support. The questions in this support form are intended to give us an accurate picture of your present circumstances, so it's very important that you answer them all, this helps us to fully assess the support that we can offer. * denotes this field is mandatory

About You

This section is about the person working in horticulture.

Name*

Title First name(s) Last name

Address*

Address line 1 Address line 2 City County Post Code

Telephone number*

Mobile

Email

Date of Birth*

What is your preferred method of contact?*

Email
Post
Mobile/Telephone

Have you accessed Perennial's services before?*

Yes
No

Do you work in horticulture?*

Yes
No

Industry Sector - Please select the most relevant area:

Other horticulture work

Employment status - Please select the most relevant area

Employed
Self-employed
Unemployed
Seeking work
Unable to work
Off work due to sickness or illness
Retired
Furlough

Working in Horticulture

What is your present job title?*

How long have you been in this role?

Present Employer name and address:

If self-employed please describe the nature of your work and business details:

Your Household Income

Is your annual household income below £30,000?*

Yes
No

Are you in receipt of means tested benefits?*

Means tested benefits can include the following: Universal credit / Child Tax Credits / Income based job seekers allowance / Employment support allowance / Housing benefit /Working tax credits / Income support / Incapacity benefit / Pension credit

Yes
No

Are you experiencing an unexpected crisis or life-changing event?*

Yes
No

Please tell us about the challenges you are facing

What you like to do

If have already started your course or you are a horticulturist student already on a course, please see our Student Support information.

Please tell us about the training and development you would like to do*

(Tell us about the course and the training include the course title and overview or description)

Please describe your career goals*

(Include how you think support from Perennial will help you to achieve these goals)

About the training

Where will it take place?*

When will it take place?*

How long will the training last?*

Who will deliver the training?*

(name of the training provider or college)

Please tell us what you would do if Perennial was unable to support you

About the costs

How much will the training cost?*

Has your employer offered to contribute to the training in anyway?

Will you suffer any loss of earnings whilst training?

Yes
No

Please give details

Are there any additional costs to consider?

(Eg equipment, travel etc)

What is the total amount you would like support for?*

Other Financial Support or Grants:

Have you applied to other organisations for assistance or grants?

Yes
No

Please tell us where and their response

Supporting Evidence

To help us assess your request for support could you attach evidence of your work in horticulture (for example a recent payslip) and / or your studies in horticulture (for example an email from your college or training provider)

Accepted file types: doc, docx, xls, xlsx, csv, pdf, jpg, heic, Max. file size: 128 MB.

Terms and conditions

On completion of your training, successful applicants are required to provide Perennial with a written and photographic report describing the training and the benefit to you and your career progression. The report will need to be sent to training@perennial.org.uk within 3 months of completing your training.

If Perennial can provide support for you during this time, do you give consent for Perennial to use your details in our publicity and general information materials? This would be used to raise awareness of the work Perennial does to support people working in horticulture and to help us fundraise for it in the future. Your choice will in no way affect the outcome of your request.

Yes
No

Declaration*

The information I have given is accurate and up to date to the best of my knowledge. I agree to Perennial using my information as set out in the Privacy Notice . (If you have told us that you are receiving means tested benefits, you may be asked to provide supporting evidence.)

First name Last name Date

How did you hear about Perennial?

Employer - the company or organisation you work for
Membership/Trade Organisation - an organisation that you pay membership to belong to eg Professional Gardeners Guild (PGG) or British Association of Landscape Industries (BALI)
Perennial marketing/events - advertisement seen on social media, website or at events
Previously accessed Perennial’s service -are receiving or have received support or advice from Perennial
Statutory Organisation - public services provided by local councils and national government
Voluntary Organisation - charities or not for profit organisations
Word of Mouth - heard from someone else

Stay in Touch

I would like to hear about the work of Perennial including latest news, promotions, campaigns and events. Please select your communication preferences:

Email
Post
Telephone

Equalities Monitoring | Strictly Confidential

It would help us to monitor the effectiveness of our work if you would answer the following questions. Your answers will not affect your application and will only be used to check whether our support is reaching all sections of the community. This information is voluntary and if you do not wish to disclose it, please select 'prefer not to say'.

Nationality and ethnic origin of your family

Please choose the options that best describe the nationality, ethnic group or background of your family. Please tick all that apply

White

English
Scottish
Welsh
Irish
Northern Irish
Gypsy/Irish traveller
Other white background

If 'Any other White background' is selected above, specify here if you wish

Mixed

White & Asian
White & black
White & black African
Other mixed background

If 'Any other Mixed background' is selected above, specify here if you wish

Asian or Asian British

Indian
Pakistani
Bangladeshi
Chinese
Other Asian background

Black or Black British

African
Caribbean
Other Black background

Other ethnic group

Arab
Any other ethnic group
Prefer not to say

Disability

Are you or any member of your family registered as disabled?

Yes
No
Prefer not to say

Also in this section:

Also in this section:

Learning and Development Request for Support Form

About You

Working in Horticulture

Your Household Income

What you like to do

About the training

About the costs

Other Financial Support or Grants:

Equalities Monitoring | Strictly Confidential

Nationality and ethnic origin of your family

About You

Working in Horticulture

Your Household Income

What you like to do

About the training

About the costs

Other Financial Support or Grants:

Equalities Monitoring | Strictly Confidential

Nationality and ethnic origin of your family

Stay in touch: