Please note that our funding is restricted to Hull and East Riding of Yorkshire area residents only and therefore we cannot accept applications from anyone outside of this area

Our discounted online shop is available to all UK residents, visit the 'shop' section of our site to browse the full range

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* Details of the person completing this form

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* Please enter your date of birth

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* Please provide your email address

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* Please provide your telephone number

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* Do you have a disability, health condition, or allergies that you would like us to be aware of?

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* How would you describe your ethnic group?

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