Self referral form.

Self Referral for Kindness Request

If you are seeking support from ProjectKindness for yourself and/or your family, please complete this form to submit your request.

Once we receive your referral, a member of the ProjectKindness team will review your information and be in touch as soon as possible to discuss how we may be able to assist.

Please note that ProjectKindness is unable to provide support with:

• Large household items (beds, fridges, washing machines, dryers, televisions, etc.)
• Mobile phones or computers
• Perishable food items (such as milk, cheese, bread, meat, fruit and vegetables)
• Adult clothing or footwear
• Food or clothing vouchers
• Medication or medical expenses
• Financial assistance

Your privacy is important to us. The information you provide will only be used by ProjectKindness to assess your request for support and will not be shared with any other party without your consent.

We appreciate you taking the time to complete this form and will respond as soon as we are able.

With kindness,
Team ProjectKindness