All sections of this application form must be completed

Stronger Families

Bulky Waste / Skip Hire Referral Form

  • Before completing this application form please ensure that you have read the Bulky Waste/Skip Hire Service Specification
  • If the form is not completed correctly this will delay the process for allocating funding.

Please complete this form electronically and return to

Please indicate service required:

Bulky Waste Referral (6 items - maximum of 2 collections) / Yes ☐ No ☐
Skip Hire Referral / Yes ☐ No ☐
Section 1 –About the lead applicant (professional) making the application
Lead Applicants Name:
Position: / Organisation:
Email: / Telephone Number:
Section 2 - About the Family
Stronger Families Family ID * FG 123[1]
(For SSID users please provide CSA-SSID number) / SSID users please provide CSA-SSID number:
Parent/Carer (s) Name: / Child/childrens name (s) and dob:
Family address and postcode:
Contact Telephone : *
(Please ensure this is provided so that collections can be arranged)
Access and risk issues at above address (for removal of waste)
(Please identify any access/risk issues including parking, access to flats, dangerous animals etc.)
Please confirm exact location for delivery of skip. FRONT/REAR of property.
Please confirm the Home Environment Assessment Tool (HEAT) has been completed by a member of the TAF and you are able to provide a copy if requested. / Yes ☐
Section 3 – Declaration
This form must be submitted electronically via the lead applicant’s email address.
Completing this declaration confirms you have read the “Bulky Waste / Skip Hire Service Specification”document and that the application is accurate, you have worked with the family to consider the best options for disposal of items and confirm hazardous waste will not be included in the collection. Furthermore where there are concerns around a tenancy due to home conditions, the housing enforcement officer will be informed of the appropriate action taken and dates when the waste will be disposed of.
Lead Applicant’s Name: Date:
Line Manager’s Name and Email Address:
Please complete Option 1 or Option 2:
Option 1: Bulky Waste
Items for disposal (maximum of 6 items) / Please provide a comprehensive list
Furniture – free standing and not fixed; wardrobes, drawers, beds, sofas, chairs, tables, book cases, cabinets, carpets, laminate flooring, curtains, free standing fires, lamps/shades, mirrors/pictures, sun tanning bed without light tubes, artificial Christmas decorations and tv aerials / 1)
2)
3)
4)
5)
6)
White Goods e.g. fridges, freezers, cookers, microwaves, dishwashers, tumble dryers, cooker hoods
Exercise Equipment e.g. weight bench and weights, exercise bike, treadmill
Garden equipment/furniture; tables and chairs, gazebo, plant pots, ponds, spades, kennels & hutches under 3ft, wheel barrows, gardening tools, rotary dryer, barbecue
Other electrical goods; coffee maker, stereo, electric lawnmower, electric heaters, iron, printer, power tools, games consoles, computer hard drive, keyboard. All televisions and any type of screen/monitor
Children’s toys – bikes, trampoline (dismantled), swings (dismantled), cars
6 bags of general household items/waste (to be lifted safely by 1 person)
Bathroom Suite; bath, toilet, sink, side panel, shower cubicle, shower tray
Fencing; wooden, metal, barbed wire, gates (6 panels or items)
Fixtures & fittings; coving, dado rails, stair/handrails, doors, door frames, kitchen units, fire surrounds, hearths, kitchen worktops, wood pieces
Radiators;single or double
Option 2: Skip Hire
Items for disposal:
☐DIY Waste / ☐Plastic / ☐Metal
☐Garden Waste / ☐Carpet / Flooring / ☐ Mattress (please state quantity)
☐Glass / ☐Paper / cardboard / ☐Other please state
☐Glass / ☐Timber/Wood
Section 4 – Data Protection
Data Protection Statement
The family’s personal details provided by the Lead Professional will be held on computer by the Think Family Team and will only be used by Durham County Council when considering this application of funding. In addition family contact details will be shared with approved service providers to allow the delivery of goods/progression of the works requested.
Section 5 – How to apply
  • Please return your completed form electronically to:
Please note: If sending this completed form from a non Durham County Council email account, please send from a GCSX account, where available, to:
  • Bulky Waste & Skip Hire referrals are assessed weekly and you can expect a response within three weeks of your application. The Stronger Families team will respond by email to all applications, successful or not.

For information on alternative sources of funding please visit our Operational Guidance at

* The family ID can be found on your confirmation email from the Think Family Data Team