Time to Live - Creative Breaks - Short BREAKS

To be eligible for Creative Break Funding you must be an unpaid carer who lives in Aberdeenshire, and has a caring role for a parent, partner, family member or friend. You do not have to be registered with our service. Any funds awarded must be used by the 30th April 2026.

If you have any issues whilst filling out this form, please contact us on carers.shire@vsa.org.uk or 01224 727670.

	Yes	No	Unsure
Are you a registered Carer with VSA Aberdeenshire Carer Service?

	Yes	No
Would you like us to contact you with more information? (Note - This will not affect your application)

Your Privacy and How We Use Your Information

The Data Protection Act 2018 and the UK General Data Protection Regulation (GDPR) lay down rules on how services (e.g. schools, health services and voluntary services) must manage information. The Information Commissioner’s Office (ICO) is an independent regulator that protects your rights when it comes to information about you.

Please read this statement carefully and let us know if you are happy for us to store, process and where relevant, share your personal information.

VSA will store and process information that you provide at the point of application or at any subsequent time in a secure and sensitive manner in line with relevant data protection legislation.

This information may be used and shared with partner organisations or anonymously for reporting and monitoring purposes.

VSA carers will not disclose any personal information provided with other organisations without explicit consent unless a person’s safety and well-being is at risk.

	Agree
I confirm that I have read and understood this declaration and give permission for my personal information to be stored, processed, and where relevant, shared.

Carer Details

	Yes	No
Is Carer aged 11 years old or younger?

Name of Parent/Guardian required if completing form on behalf of Young Carer

Carer Date of Birth

Carer Title

Carer First Name

Carer Last Name

Carer Address - Street

Carer Address - Town/City

Carer Address - Region/County

Carer Address - Country

Carer Address - Postcode

Carer Telephone Number

Carer Mobile

Carer Preferred Email Address

Carer Ethnicity

Carer Nationality

	Yes	No
Do you live in a rural location

Grant Details

How much are you applying for (£)

Maximum grant award is £400

How will you use your grant?

Press CTRL key and click to select multiple options

Please provide more information on how you will use your grant (where you intend to stay, what you intend to purchase):

Please give a short summary of how you feel this award will help you, and your cared for’s wellbeing and how it might help you continue in your caring role.

How did you hear about the grant?

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If Other, please provide details

	Yes
I agree to provide receipts upon request for the use of my award

Cared For Details

Cared For Date of Birth

Cared For Title

Cared For First Name

Cared For Last Name

Cared For Relationship To You

	Yes	No
Do you stay at the same address as the Carer?

Cared For Address - Street

Cared For Address - Town/City

Cared For Address - Region/County

Cared For Address - Country

Cared For Address - Postcode

Conditions affecting Cared For

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If Other, please provide details

If you care for more than one person, please click on "Add another response" below to add details of another cared for.

Data Protection

The information collected on this form is recorded manually and on computer, stored securely and processed for the purpose of providing you with a support service. VSA will process your information fairly and lawfully, and in accordance with the principles of the Data Protection Act 2018. Your information will be shared with the other agencies involved in providing you with support. You have already agreed to this information being shared by signing the Consent to Share form.

For the purposes of processing your personal information, VSA is the Data Controller you have a right to obtain details of the personal information which VSA holds about you. Such a request should be made in writing to Data.Protecton@vsa.org.uk

	Yes	No	Unsure
Will your cared for attend any part of the break with you?
Have you received this type of grant before?