CHALLENGE GRANT APPLICATION

Details of person with MND:

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Gender:*
Have you previously received a grant from Challenging MND?*
Are you completeing the application on behalf of the person above?

Your details (if different from above):

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Gender:
Has the person with MND consented to this application and the sharing of their personal information?

Details of Memorable Event or Challenge:

Declaration:

Please note: your details WILL NOT be passed onto any other 3rd parties.

Important Note:

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Max File Size 15MB

Unfortunately, no applications can be considered without proof of diagnosis.

 

©2019 by CHALLENGING MND.
CHALLENGING MND is a registered charity in England and Wales (1182607)