Cura Grant

Name (required)

Email (required)

Phone number (required)

Tell us exactly what you would spend the funds on? Please note we will prioritise applications for immediate and specific needs. (required)

This grant is aimed at people who are struggling financially. Can you afford to purchase this yourself? (required)

What difference would the grant make to you? (required)

Who suggested you apply for the grant? This must be a member of staff at E&N Herts NHS (this includes Mount Vernon Cancer Centre). Without the staff name, with whom we may discuss your application, the form will be invalid. (required)

How did you hear about us (required)

Word of mouthA leaflet or posterA member of staff

Please provide bank details - name (required)

Bank (required)

Sort Code (required)

Account Number (required)