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Self Referral

Thank you for your interest in receiving supportive cancer care from Nankind. Please ensure that all fields flagged are completed otherwise your application will not be submitted, once completed a Child Life Specialist will be in touch with you shortly to discuss next steps. You'll know your application was successfully submitted if when you click the 'Submit Application' button you see application submitted. Please note: We support residents of Ontario only.

Contact Information

First name
Last name
Email Address
Cell Phone

Additional Info

Client - Request a Volunteer Angel
Are you diagnosed with cancer?
Type of Cancer
How many children do you you have under the age of 16?
How did you hear about Nankind (formerly Nanny Angel Network)?