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Apply For Assistance STA Form

Application for Assistance

STA FUND ADMINISTRATED BY THE ACTORS BENEVOLENT FUND OF NSW

www.actorsbenevolentfund.org.au

Our Rules of Association allow us to:

Raise and accumulate funds in order to provide financial and/or other assistance to members of the entertainment profession as defined in the Guidelines. Financial assistance may be provided in cases of hardship due to injury, illness, accident or disability for the member for such period and in such manner as the Management Committee deems fit.

Please note: We are only able to assist those residing in NSW. Other States have their own Benevolent Funds, or similar. Information given in this document is confidential.

Thank you - your request has been sent successfully.

Please provide the name and contact number of a person close to you:

The fund, under certain circumstances and at the discretion of the committee, will provide one-off grants up to $3,000 to assist with urgent and significant medical and living expenses resulting from mental health issues.

Grants made under this program are non-repayable and it is understood that the recipient would suffer significant financial hardship without this grant. An acquittal of the funds is required to be submitted to STA FUND within 6 months of the grant being given.

Eligibility

  • You are a current resident of NSW.
  • You have worked professionally in theatre for a minimum of 3 years (During that period we accept that you may also have worked in other mediums such as radio, film and TV however you must be predominately a theatre person).
  • You demonstrate financial need.
  • You supply a written quote of proposed medical treatment.
  • You supply a letter of support from a medical practitioner outlining the importance and benefit of the treatment and outcome to your standard of living.
Please select an option.

Please complete the following request for information

To help us process your request, we are required to ask you for the following information about your financial circumstances.

Income

Please list your annual income from:

Assets

Please list the approximate value of your assets.

Expenses

Please give us an approximation of your monthly expenses.

NOTE: We would appreciate a letter or other documentation from an accountant, bank manager, or responsible person known to you, confirming the financial information above.

Please forward copies of your documentation either by email to: info@actorsbenevolentfund.org.au or post to Actors Benevolent Fund of NSW, 245 Chalmers Street, Redfern. NSW 2016. All details you give are strictly confidential and will never be made public.

Living Arrangements

Medical and Health Information

To help us assess your application, please describe to us your illness and/or any other detail relating to the reasons for your request for assistance.

NOTE: You are required to supply a letter, medical certificate, or other documentation from a doctor or other registered medical or dental professional confirming the Medical and Health information above.

Declaration

I understand that the details in this application are confidential and will never be made public. The Actors Benevolent Fund of NSW on behalf of the STA Fund reserves the right to make discreet enquiries about the information provided.

I also understand that, should I be granted assistance, I will inform the STA Fund of any changes to my current circumstances which may affect my eligibility for assistance. I also undertake to provide the Fund with any updated information as may be requested from time to time.

By typing your name in this box (on this form) you agree to abide by the terms and conditions of the grant/loan and certify that all the information is true and correct to the best of your knowledge.

If using hard copy you can post this form, together with any letters or documentation to: Actors Benevolent Fund of NSW, 245 Chalmers St, Redfern, NSW 2016 • Or scan or photograph all the documents and email to: info@actorsbenevolentfund.org.au