Saskatchewan Family Grant Application

Please complete all sections of this application. Applications missing required components or documentation may not be considered. Submit completed application and supporting documents through the form below.

Questions related to the grant may be sent to: skgrant@moveforlifefoundation.com

Applicants will be notified of decisions within two weeks of the application closing.

DEADLINE: MAY 31st, 2025 @ 11:59pm CST

Consent of a minor

The application is intended for transplant recipients ages <18 years of age. The legal guardian must consent to the disclosure of medial health information.

YES

NO

Applicant Name

First Name

Last Name

Transplant Recipient Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email

Phone

(###)

###

####

Purpose of Funding

Provide a statement (Max. 500 words) explaining how this grant will assist you including: - Brief description of your current situation, financial need, how the grant will benefit you and/or your family - Specific use of funds (e.g., travel, accommodations, therapy, medication, physical activity programs, etc.). - How the funding will support the transplant recipient’s well-being.

Have you previously applied for this grant, or other grants for this purpose?

YES

NO

Are you using online platforms (ex. GoFundMe) to raise funds that contribute to receiving medical care?

YES

NO

Are you willing to share your story with Move For Life Foundation for transplant awareness (social media, Newsletter, etc.)

YES

NO

What is your preferred method for contact

Acknowledge Statement

By submitting below, I confirm that the information provided in this application is accurate. I understand that incomplete or false information may result in my application being denied.