Please allow about 15-20 minutes to complete this form.
If you have any difficulties with any of the questions shown on the form, please call the Guild of Benevolence on 020 7382 2644 or email the Guild for assistance here.
If you already recieve assistance and need to complete an assessment for continued financial support, please complete this form.
The ‘Institute’ refers to the Institute of Marine Engineering, Science and Technology.
Past and present members of the Institute and past and present members of the Guild of Benevolence
Please provide the WEEKLY income for each and any of the following sources, including any from a spouse or partner.
Only enter numbers in numeric form, e.g. '50.00' or '150.75'.
For each and any of the below, please enter the purchase dates, frequency, and total amount of debt incurred.
Detail both the weekly expenditure and any costs in arrears.
For example, if you spend £700 a month on your mortgage but have £400 in arrears, write it as '£175 (weekly), £400 (arrears)'.