Decorate A Child's Life

Decorate A Child's Life

To complete this form, you will need: information on the furniture the family requires, dates the family are available and photos of the bedrooms. We only work in London. We receive lots of referrals and can take up to a week to respond.
Referrer's name *
Referrer's organisation *
Referrer's email *
Referrer's phone number *
Main family contact name *
Main family contact number *
Family contact address *
Which London borough is the family home in? *
Number of children in household *

1 2 3 4 5+
Children's details *
Number of bedrooms referred *

1 2 3 4+
Reason(s) for referral *

Overcrowding Damp/mould Needs decorating Lack of furniture Accessibility/additional needs of the child Other
If other, please outline below:
Housing situation *

Council tenant Private tenant Home owner Temporary accommodation Other
If other, please outline below:
Property condition - we cannot work in properties with major damages e.g., structural issues/exposed wiring *

Minor damages (e.g., damp/mould, flooring issues) Good condition Other
If other, please outline below:
How can we best support this family? *

With a full bedroom redecoration (painting and new furniture) By supplying new bedroom furniture items
If there is anything helpful for us to know about the accommodation or family situation, please add it here
Bedroom Redecoration
Photos of the bedroom(s)

We require photos of the current condition of the bedroom(s) to ensure that the property is suitable for the programme.
Please upload the photos here *

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Cancel of
Site visit

To progress the application, we will need to attend a site visit to take measurements, photos and speak to the children about their ideas. We request that the referral partner is also present for this visit. It usually takes around 30 minutes.
Please select a date for the site visit *

Month Day Year
Date
Informed Consent
Please read this form carefully.
- I agree to support my referred family throughout their participation in the Decorate A Child’s Life programme.
- I understand that projects require the referral partner to be present throughout project planning and delivery, which can take up to 3 months.
- I agree to cooperate with Decorate A Child’s Life Project Managers throughout project planning, and I will communicate any concerns I have to them as soon as they arise.
- I will disclose any relevant information regarding the family’s well-being, housing circumstances, relationship with Social Services, and family members’ special needs and capabilities.
- I understand that Decorate A Child’s Life Project Managers will be in regular contact with me throughout the project planning process, and I agree to be responsive and promptly provide confirmation on project plans when asked.
I have gone through the 'Terms of Participation' document with the participating family and they have agreed to the terms: *

Yes
Alternate referral partner contact: *
We will only use this contact in the case that you are away on leave or uncontactable
By submitting this form, you have agreed to the terms above
Furniture Provision
Beds required *

0 1 2 3 4
Type of bed *

Bunk bed Single bed Toddler bed Cot None
Bedding sets required *

0 1 2 3 4
Chest of drawers required *

0 1 2
Wardrobes required *

0 1 2
Desks required *

0 1 2
Chairs required *

0 1 2
Colour preferences & interests of child/children *
Furniture assembly assistance required (furniture will be flatpack) - this usually takes place the day after delivery of the furniture *

Yes No
Other information or requirements:
Is there any other item that the child wants apart from the ones already listed?
Please offer 2 potential dates for delivery at least two weeks in advance
Date *

Month Day Year
Date
Date *

Month Day Year
Date
Should be Empty:

Decorate A Child's Life

Bedroom Redecoration

Photos of the bedroom(s)

Site visit

Informed Consent

Furniture Provision

Please offer 2 potential dates for delivery at least two weeks in advance