0800 66 0800 info@testicular.org.nz

Welfare Grants Fund

We understand that a diagnosis of prostate or testicular cancer can place a considerable financial burden on not just the person diagnosed but also their families, including loss of income and additional costs associated with the consequences of treatment. To assist patients and their families who are experiencing hardship related to their treatment for prostate or testicular cancer, we provide assistance through our Welfare Grants Fund. 

Applications can be made online via the link below. Alternatively download and use the printable Application Form (see link below). Please also see this same form for the full Terms & Conditions, and the Privacy Policy linked in the footer. Copies of this document are also available on request from the National Office – phone 0800 477 678. Welfare Grants Fund Application Form (PDF)

The Welfare Grants Fund is supported by the Dry July NZ Trust.

Welfare Grant Application Form

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Welfare Grants Fund Application

Please complete all the details below, in full.

Details of Applicant

Name
Your Address
Does this application relate to Prostate Cancer or Testicular Cancer
Are you a PCFNZ Member?
Have you applied for Ministry of Health National Travel Assistance?

For grants for Partners or Family / Whanau

Supporting Documents and Declaration

Checklist
Max. file size: 256 MB.
Marketing Opt-In
Declaration(Required)