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Reapply for Additional Help

Need some more assistance? We can help.

We are here to help. More.

If you’ve applied for and received financial assistance from the Pink Wig Foundation and would like to apply again to receive additional help, we’ve created a slightly more streamlined application process for you.

You are eligible to reapply for funding only if you have completed a full application within the last 12 months

Please fill out the form below and we’ll be in touch with you to discuss how we might be able to provide assistance.

Applicants are invited to apply at any time but funding is awarded following the deadlines below:

  • January 1st
  • April 1st
  • July 1st
  • October 1st

Full out this form to reapply for assistance. When we receive your request, we'll be in touch to learn a little bit more about you and how we can help out again.

Important Note: information sent to us through this form is secure. All traffic through our website is encrypted.

    Your Name (required)

    Your Email (required)

    Your Phone Number (required)

    I am applying for assistance on behalf of:

    Name of the applicant (required)

    Is the applicant between the ages of 16 and 50?

    Yes

    Age of the applicant (required)

    Is the applicant a resident of Saskatchewan?

    Yes

    Applicant's home location (City, Street, Postal Code) (required)

    Initial diagnosis date (required)

    Number of dependents

    How many km (one way) do you live from a cancer treatment centre?

    How is your diagnosis considered?

    curative intentpalliative intent

    What state of treatment are you at? (Active treatment defined as Chemotherapy/Immunotherapy/Combination therapy/RT therapy or surgery within 3 months)

    diagnosed and waiting for treatmentcurrently in active treatment (does not include maintenance)surgery within 3 months of application - no additional treatmentcurrently undergoing maintenance treatmentno treatment required at this time

    If yes, please explain how

    Please tell us why you continue to financially need our help (250 words or less) (required)

    The PinkWig Foundation was created in honor of Tracy Dinh. Tracy embodied qualities of independence, determination, selflessness, loyalty, and compassion. Please describe how you continue to embody the qualities of independence, determination, selflessness, loyalty and compassion that were present with Tracy. (250 words or less) (required)

    Please include information for an alternate contact person. This person will only be contacted in the event we are not able to reach the applicant.

    Alternate Contact - Full Name

    Alternate Contact - Email

    Alternate Contact - Phone Number

    Have you had any changes to your income since your last application?

    YesNo

    If yes, please upload any changed copies of the following:

    1) Please upload a scanned copy of your most recent tax return (or notice of assessment) (Max size: 5MB)

    2) Please upload a scanned copy of your spouse's/common law partner's most recent tax return (or notice of assessment) (Max size: 5MB)

    3) Please upload verification of any disability payments you are receiving (if applicable) (Max size: 2MB)

    4) Please upload a copy of any other forms of insurance that you are currently receiving (if applicable)(Max size: 2MB)