Your Full Name (required)

UCU membership number (required)

Your Email (required)

Your Telephone Number (required)

Other Telephone Number (optional)

Confirm you have already applied for the UCU national Fighting Fund, enclosing your Fighting Fund reference number (required)

Your Residential Address (required)

Explain the circumstances of your Hardship Fund claim. Here only the essential details are needed (required)

File attachment 1, suggested formats are PDF, JPG, PNG (required)

* If you are claiming total deductions and submit evidence of periods striking, please include a Word file containing screenshots of periods striking from CORE or similar evidence. If you are applying for Hardship Fund on the basis of a single month/payslip, we will fund you the value of days represented by that payslip, IF YOU WISH TO APPLY FOR FURTHER PAYSLIPS, PLEASE MAKE A FURTHER APPLICATION FOR THOSE PAYSLIPS. If you are applying for the total amount in June, please include further payslips using the file upload options below. For difficulties you can alternatively use the office email address (shown below) to supply all required data and attachments.

Other File attachment 2, suggested formats are PDF, JPG, PNG (optional)

Other File attachment 3, suggested formats are PDF, JPG, PNG (optional)

Total number of strike days you declared/ were on strike (required)

* note the Hardship Fund will compensate for the days minus the first 3 days of industrial action in line with national UCU regulations. For the above option, please supply the TOTAL number of days you were on strike, INCLUDING the first 3 days.

For problems using this form, please alternatively email the branch office, including all the above details/ attachments at lucu@liverpool.ac.uk