Serious Illness and Emergency – Form

Funding to assist a terminally ill or seriously ill AM-YAC Member and their immediate family. 

An immediate family member is to be nominated to communicate with the Executive Office. 

A letter from the hospital or a doctor must be provided with the first application to verify the condition requires ongoing treatment and/or a visit to a medical specialist. 

Support that can be provided may include: 

  • Medical related costs not covered by the government. 
  • Immediate family travel costs (between towns and cities) to attend the bedside of a seriously ill or terminally ill AM-YAC Member. 
  • Accommodation.
  • Food.
  • Other key factors.

To apply, submit the form.

You will receive a confirmation email when your application has been received.

SERVICE STANDARDS

If your application is consistent with trust policies and budget you can expect approval within three business days.

Online Application Form

If you prefer you can download and email back the application form to trust@amyac.com.au