INSTRUCTIONS

a) Each applicant must complete the Application Form.
b) Applications must be received at Childcan's office no later than midnight on June 26, 2026.
c) Applications received after this date will not be considered. No exceptions.

ELIGIBILITY
a) You must have been treated for some form of childhood cancer, or still be on treatment.
b) You must provide a letter from a Physician, Nurse Case Manager, Nurse Practitioner, or Social Worker stating you have been previously treated or are being treated presently for childhood cancer.
c) You MUST be enrolled with Childcan. You were previously enrolled with Childcan when initially diagnosed or treated through Children’s Hospital’s Paediatric Oncology services at London Health Sciences Centre (LHSC), London, Ontario, OR previously enrolled with Childcan and were diagnosed/treated outside of LHSC. If you have not been enrolled with Childcan, you will NOT be eligible for a bursary. Please contact us if you have any questions about this.
d) You are a Canadian Citizen or Permanent Resident.
e) You must be at least 17 years of age.
f) You must provide a letter of acceptance and proof of enrollment/registration (course selection, timetable, tuition payment etc.) to your post secondary education institute or apprentice program verifying your application for studies and acceptance.
g) You are only eligible to be awarded this bursary once in the course of your post secondary studies. You are, however, eligible to apply more than once if you have not been successful the first time.
h) You must provide a letter of reference from a teacher or community member.
i) You must agree that Childcan will publish your name as award recipient in an upcoming newsletter, on its website and/or through social media and reserves the right to otherwise promote the recipients. By submitting an application, you are acknowledging and agreeing to this.

You will be notified on screen once your application has been successfully submitted and award recipients will be notified in writing by the beginning of August. Successful applicants will be required to share their birthdate and SIN in order to receive funds.
Tell us about you

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* 1. First and Last Name

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* 2. Street Number and Address

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* 3. City, Province, and Postal Code

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* 4. Phone Number

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* 5. Email

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* 6. Citizenship Status

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* 7. Type of Childhood Cancer

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* 8. Are you currently in treatment?

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* 9. Treatment End Date

Date

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* 10. Name of the High School where you graduated

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* 11. Date Graduated

Date

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* 12. Name of Post Secondary Education Insitute applied to

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* 13. Name of the Program you will enter

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* 14. Have you ever volunteered for a Childcan event?

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* 15. If yes, please describe your involvement as a volunteer

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* 16. Childcan's mission is to raise awareness and funds to provide personalized, responsive, and compassionate programs and services to families facing the childhood cancer journey from diagnosis, through treatment, post-treatment care, or bereavement. How has Childcan supported you and your family following your cancer diagnosis?

Document Upload

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* 17. Please upload your Letter of Interest

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* 18. Please upload your letter from a Health Care Professional

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* 19. Please upload your letter of acceptance and proof of enrollment (course selection, timetable, tuition payment etc.) from your post secondary education institute

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* 20. Please upload your letter of reference from a teacher or community member.

Optional Questions

The next two questions are optional but, if you are successful, we will need these questions answered before funds can be released.

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* 21. Please provide your date of birth

Date

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* 22. Please provide your SIN number

Signatures

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* 23. Applicants Signature

By checking the box below, you agree to be applying for the bursary, that all your responses are true, and your information is to be shared with the bursary review committee.

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* 24. Signature of Parent / Guardian

By checking the box below, you agree that your child is to be applying for the bursary, that all the responses are true, and the information is to be shared with the bursary review committee.

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* 25. Date

By checking the box below and providing today's date, you agree to be applying for the bursary, that all the responses are true, and that the information submitted is to be shared with the bursary review committee. If successful, you also agree to share your birthdate and SIN when requested, if you have not already done so as part of this application.

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Thank you for applying.

We wish you luck and look forward to receiving your application.

If you have any questions, please contact:

Lorraine Jewell, Windsor Family Support and Community Engagement Liaison
lorraine@childcan.com or call 226-345-0415 or 519-685-3500

Click submit to complete this form.

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