Trauma Assistance Fund for Freelancers

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This fund provides free, timely, time-limited and confidential counselling for eligible Canadian or foreign freelance journalists in Canada or abroad, as defined below, who have experienced mental health issues in response to an acute work-related stressor. In order to respond to your request for assistance, some initial information is required on a confidential basis.

Your name:

Your email address: *

Your full home address: *

Your telephone number including country code if outside of Canada *

Your date of birth: *

YYYY

Your nationality and, if applicable, your Canadian immigration status: *

Please list the languages in which you are fluent

The fund is open to applications from freelancers working in any form of journalism who fit one of three categories. Please indicate the one which applies to you.

Canadian freelancers, wherever they live, who are fluent in English or French.

Foreigners legally resident in Canada, working for external media in English or French.

Foreigners resident elsewhere working for Canadian media in English or French.

Other:

Required

If you checked "other" in the question above please describe your circumstances, telling us why you think your application should still be considered.

Please tell us generally about the kinds of journalism you do: *

Which of these would you say represent/s your main role/s? Check all that apply. *

Reporter

Photojournalist/videojournalist

Camera operator

Video/audio editor

Producer

Fixer

Other:

Required

If you chose other, please explain here:

To confirm your independent status, please tick any of the boxes below which apply to your situation:

I have no arrangement with any media organization providing access to supplementary healthcare benefits

I have no arrangement with any freelance association providing access to supplementary health benefits

I have no arrangement with any freelance news agency providing access to supplementary health benefits

Required

If you left a box above unchecked, please explain why:

Please explain briefly why you are applying for short-term counselling for a recent work-related event:

The information provided is correct.

I submit this application accordingly

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