Fall Intake is open from October 1 to 31, 2018


* Please read the following before applying! *

Please ensure you have read through the Fund Policy prior to filling out an application. All applicants require a referring church or non-profit agency to apply on their behalf.

Please complete the application form to the best of your ability. All fields marked with an asterisk (*) require a response.

You may find it helpful to record your answers in a separate Word document, and then copy & paste them into the appropriate questions.

The information submitted in your application will remain private & confidential, and is only viewed for the purposes of the Survivor Support Fund Committee as well as for the collection of anonymous statistics.

If you have any questions about the application process, please contact Debbie Pond, Survivor Support Fund Coordinator by email.

Thank you for applying!


The following information should be submitted by the church or non-profit agency who is making a referral on behalf of an applicant.








* How did you hear about the Defend Dignity Survivor Support Fund?:


Note: The following questions pertain to the applicant him/herself.





* Is the applicant an official Canadian citizen?



* Is the applicant of Indigenous descent?



* What is the applicant's gender?


* In what way(s) has the applicant experienced sexual exploitation of any kind? Please check all that apply.


If this individual has been trafficked for the purpose of sexual exploitation, was he/she trafficked:


* Is the applicant on social assistance from the provincial government (e.g. Ontario Works, Alberta Works, etc.)?







Before submitting your application form, please note:


*** As per our policy, along with your completed form, all applications also require a copy of the following emailed to Debbie Pond, Survivor Support Fund Coordinator. ***

1) A signed waiver form
2) A letter from the applicant
3) A referral letter from the supporting church/agency
--> For more information on what to include in the applicant and referral letters, please read here.

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