This form is to be used to claim travel cost associated with gender affirming
surgery for members of the transgender community living in Northwestern Ontario. Each applicant is eligible to receive 20% of the money currently in the fund, up to a maximum amount of $200.00 CAD.
This fund is completely community-funded. If you would like to make a donation, please email email@example.com.
Please utilize this grant only if you do not qualify for the Northern Health Travel Grant (administered by OHIP)
Note that you do not have to be a student to apply for this grant.
You must be residing in Northwestern Ontario.
You must be receiving gender affirming surgery (any surgery, including surgeries not covered by OHIP, which you are seeking as a means of affirming gender identity/ expression, and/ or alleviating gender dysphoria)
Complete all fields and be sure to attach any requested documentation and
receipts. THIS IS A REIMBURSEMENT FORM, please only use this form after you have purchased plane tickets and have a receipt (or gas receipts if you are driving).
Please download the form below, fill it out, and then email to firstname.lastname@example.org and email@example.com.