Apply Health Fund

MEMBER BENEFIT! The Health Fund provides reimbursement to active VLSCS members to cover full or partial costs for health-related items / services that are not funded by other extended health coverage or provincial subsidies.
A designated amount of proceeds from the GALA and other fund-raising efforts go directly towards our Health Fund
Before completing this application please read the Program Overview Here:

    Your Name (required)

    Your Email (required)

    Your Address

    Your Telephone

    Describe Your Health Need and Requested Amount

    Date:
    YYYY-MM-DD format (e.g. 2013-04-08)

    Human? Complete the box below.
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