How To Apply

Click here to Download the Application Form

Applying is simple. First of all fill out details about yourself (Section 1).

You will also need to ask a healthcare professional to complete Sections 2 & 3. This can be a nurse, GP, registrar or consultant, who you see regularly and is familiar with your condition.

Once your form is completed, you can post it back to Whole in my bucket using the following address: Whole in my bucket, c/o Benjamins Boutique, queen street, Horbury, WF46LP

Alternatively, you can submit by scanning and emailing it to

You can also call us to check the application has arrived or progress on 07376 529 607.