Application

Fill the form below to apply for assistance for significant financial hardship

Please note: you will receive an email confirmation on completion of this form if you do not receive an email please contact your Retailer.

First and Last Name *

When did you start working for this retailer? *

Email *

Reason for Financial Hardship *

Financial circumstances *

Alternative Funding *

What is the amount you need from the Foundation (maximum $3,000)? *

Specific Costs

Upload a supporting files

I consent to the Trustees contacting you or your Retailer for further information and to advise of the outcome.

I have read and understood the Z Foundation Grant Criteria.