Fiancial Aid Request

The GAETQ (Québec Parent Association) offers financial help to families who will request it.

Fill in the online form and we will evaluate the amount that you can receive.

Don’t hesitate to contact us if you have questions.

Note: Families outside Québec can ask for a maximum of three hotel nights. Families from Québec, outside the Saguenay-Lac-Saint-Jean region, can ask for a maximum of two nights. People from the region, living further than 60 km, can ask for one night.

Full name (Required)

Complete address including town, province/state, postal code and country (Required)

Phone (Required)

Email (Required)

Name of affected person

Link with this person  Father Mother Affected person

Description Amount
Traveling by car : km x 0,12 $ = $
Traveling by bus
(1 ticket allowed - include ticket / receipt) =
$
Traveling by plane
(1 ticket allowed - include ticket / receipt) =
$
Hotel or Night (see annex) $
Total Amount requested = $

Include all tickets and receipts (1 PDF or Word file, 10mb max)

 I certify that these expenses where made to attend the Tyrosinemia 2015 International Conference
No insurance or other governmental program could reimburse these expenses.

Pin It on Pinterest

Share This