Care place application form

Martha Trust cares for people with profound physical and multiple learning disabilities. We provide residential, respite care and day care in purpose-built ‘family’ homes that offer the highest standards of nursing care and state-of-the-art facilities. To register your interest in a care place with Martha Trust, simply complete the form below.

Details of person requiring care

Details of person enquiring

Martha Trust would like to keep you updated on our future news, fundraising activities and ways to support us. To opt in to receiving information from Martha Trust, please tick how you would prefer to be contacted:


or email

We do not sell or swap your details with any third parties, but in order to carry out our work we may need to pass your details on to services companies authorised to act on our behalf.

Next of kin details (if not as above)

Care manager details (if not as above)

Martha House, DealFrances House, DealMary House, Hastings
ResidentialRespiteDay care