Request

You can be assured that all information that you provide is treated confidentially. Please note, by typing your name you are consenting to sharing your information with Sleapy’s Foundation review committee.

For more information on our Privacy Policy, please visit our policy here on our website.

We appreciate that this is a stressful time, so will endeavour to consider your application and provide you with an outcome as soon as possible.

If you require any additional support to complete your application or have any questions, we’re here to help.
Please contact Robynn Sleap on 0423 956756 or admin@sleapysfoundation.com.au
our Beneficiary Care Coordinator on (02) 4062 8883 or care@sleapysfoundation.com.au for assistance.

Please note that Sleapy’s Foundation is currently only accepting applications for request for assistance from those in the Hunter New England area. From time to time, special cases may be considered outside of this area.

Person (s) Initiating Application

Relationship to Person requiring assistance:

Person (s) Requiring Assistance

Relationship Status

Single Married DeFacto

What type of hardship are you experiencing?

Please provide details of your current situation:

Provide a brief history of Illness / adversity along with short and long term outcome scenarios.

Have you received any assistance from charitable or other organisations previously? If yes, please provide details including amounts received and purpose.

Please state how assistance from Sleapys Foundation will benefit the applicant or person requiring assistance and detail what kind of assistance Is required, e.g., direct funding, counselling, respite etc.

Please be very specific with the purpose and the amount(s) required as this will assist us in making a decision.

Please upload additional evidence to support your application that assistance will support the quality of life of a child or adult. Examples of supporting evidence are listed below. Under the list is the option to upload your file.

Doctors/Specialists referrals and medical information Workplace Termination letter Copies of rent or mortgage /other loan payments Bank statements Utility Bills Proof of income / expenses Evidence of any other support being received eg. from other charities

Please see the guidelines here to assess your application before submitting.

Please Note: You the applicant has the right to confidentiality and privacy in regard to the outcome of your application. However, the Foundation does find sharing the testimony and stories, with your consent, about the assistance we provide helps to extend our reach and enhance our ability to assist more people.

Yes, I am willing to participate in sharing my story. No, I do not wish my story to be shared publicly.

I understand that by giving my consent, Sleapy’s Foundation may use the photograph, video or audio recording taken of me. The Foundation may reproduce the image/s in any form, in whole or in part, and distribute the works by any medium (including online, social media, direct mail, flyers, publications, case study, newsprint and multimedia) for the purposes of education, promotion, fundraising and marketing. I understand that the Foundation will not pay me for giving this consent or for the use of my image(s), may keep the image(s) on record until I revoke my consent, will return or destroy images if I withdraw this consent (with the exception of those already published), may use the image in the future unless I specify limitations for its use and will not infringe the rights of any third party by exercising its rights given in this consent.
I give consent to the Foundation to make, use and/or retain an image(s) that may identify me, my child or an individual for whom I have authorised decision-making responsibility.
I understand that I can withdraw or modify my consent at any time in writing to

Sleapy’s Foundation,
3/152 Darby Street, Cooks Hill NSW 2300
or admin@sleapysfoundation.com.au

Application For Assistance Form

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