Short Break Application Form

Guidance Notes
If you have had a short break within the last 12 months you will not be eligible to apply for a short break until 12 months after your last break. You must not book or pay for any break prior to approval. If your short break is booked/pre-ordered or paid for before being approved, then your application will be rejected. Completed applications will be considered as soon as possible. By submitting this application form you declare that the information on this form is accurate.We are unable to provide updates on the progress of applications, all Carers will be notified on the outcome of applications as soon as possible.
Parent Carers of under 25's please note:
Before any application will be processed by the Inverclyde Carers Centre short breaks panel, we will ask Parent Carers if they have applied to the Family Fund (Take a Break) where your child has a disability or serious illness. If applications to the Family Fund are unsuccessful, Carers must share evidence of this to allow the panel to process their application. Parent Carers should apply via the Take a Break Scotland or Family Fund websites.
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Cared for details
Break Information
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