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Application for Assistance

Please fill out the form below and submit for consideration. We also require a doctor’s note confirming the diagnosis (1 page max.), as well as at least one quote for the item/camp/therapy you are requesting. Please scan and upload these documents, save them as “CHILDS NAME – DOCUMENT NAME” then send them to info@fortheloveofachild.ca

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY