Memory and Funeral Grant Application Form
Please provide the details for the best person to contact so that we can arrange to provide the grant to the family.
This could be the parent themselves, a spouse, family member or a support person such as a social worker.
Name of terminally ill parent
Are you applying for a grant for a family with a parent who has a terminal illness, with children aged under 13.
Is the parent a NSW resident or being treated primarily in a NSW hospital?
Please upload a letter from a treating doctor stating that the patient has a terminal illness, and listing the names and ages of any children under 13.
Please give us a short explanation of how you will use the funds.
How did you hear about us?