1 Client details
The person who needs help. Use the name as it appears on their documents if they have any.
About this application
2 Sponsor, guardian and next of kin
These are different roles. One person can have more than one, but please say which. A sponsor is not automatically a guardian, and a next of kin cannot make decisions for the person unless they are a guardian.
Is there a sponsor or proposed financial supporter? Someone, or an organisation, who may help with costs. You can apply without one. No Yes
Is a parent, legal guardian or other representative involved? Needed when the person is under 18 or cannot give their own consent. No Yes
Next of kin or emergency contact
Add a second contact
3 Referral and payment
Proposed payment or funding
This only tells us what is planned. Nothing is charged to apply. BICA confirms fees and funding in writing after assessment, and a sponsor's offer is not a binding commitment.
How is the cost of support expected to be met? (required) Choose... Self-funded or fee-paying Sponsor-funded Family-funded Insurance-funded Grant-funded BICA-supported or subsidised Mixed funding Funding not yet confirmed Other
Short note about the financial situation or proposed support (optional) No sponsor yet? You can still apply. Tell us what you can, and our team will talk with you about options.
4 Supporting documents
Optional, but they help us decide faster. Accepted: PDF, JPG or PNG , up to 6 MB each . Files are stored privately and only authorised BICA staff can open them. No ID? Skip it and tell us in section 1; we have another way to confirm identity.
Files you attach are not kept if the form shows an error. Please attach them again before sending.
5 Consent and declaration
Please read each statement. Items marked required are needed to process the application. Read our privacy notice (opens in a new tab).
The information I have given is true and complete as far as I know. (required)
BICA may process the personal information in this application to register, assess and decide on admission. (required)
BICA may contact the person applying, or their authorised representative, about this application. (required)
BICA may contact the sponsor named in this application about the proposed sponsorship. (required)
BICA may contact the next of kin or emergency contact named in this application for the stated purpose. This does not allow BICA to disclose sensitive information to them. (required if you named a next of kin)
BICA may share relevant information with authorised referral partners or care professionals where necessary and permitted. (Optional)
BICA may store and process the supporting medical or referral documents I upload. (required if you attach documents)
BICA may ask me separately about photography or publicity use. Ticking this box is optional and does not affect the application. (Optional)
Who is giving this consent?
If the person is a child or cannot decide for themselves, a parent, legal guardian or authorised representative must give consent.
6 Review and submit
Check your answers. You can go back to any section to change them. When you send, you will get an application reference and a secure link to follow progress.
Your answers will be listed here. (This summary needs JavaScript. Without it, scroll up to check each section.)
Send application
Save and finish later
If your connection drops, just press Send application again. We will not create a second application.