Beds For Kids Referral Form

Please complete to form below to refer a person/family to End Furniture Poverty’s Beds for Kids scheme. If you have any problems or queries, please contact Paul Colligan on 0151 305 5229 or

Referral Agent Name *
Referral Agent Name
What organisation are you from?
Your phone number
Name of Referral *
Name of Referral
Who is the person receiving the bed?
Where does the person receiving the bed live?
Phone number of person receiving bed - needed for delivery
Tell us a little bit about the situation and why the family needs a bed