To apply for a stay at "A House for Karen" the following form is to be completed in full and returned to P. O Box 300 Cambridge
or e-mailed to
Click the link to download the A House for Karen Application Form in pdf format...
...or fill in the Online Application Form below.
E-mail applications can be made online from our web site: www.ahouseforkaren.co.nz. Hard Copy Forms are also available from:
The Cancer Society-Taranaki, 71 Lorna Street, Westown, New Plymouth. Hospice Te Rangimarie, 5 David Street, Westown, New Plymouth.
Please read our "Guidelines & Expectations" before filling out this form.
‘Guidelines and Expectations’ when staying at the house
On November 6th 2003 Karen Van Dillen lost her fight with cancer, aged 44.
In her memory, a charitable trust (The Karen Cornelia Trust) ‘KCT’ was set up by her husband Ron with the
idea of building a holiday home as a haven for families suffering with cancer or any other serious illness.
The Trustees kindly request that people staying at the house respect the property and abide by a few
simple guidelines to ensure that the house is being used appropriately in the spirit that it was established.
- No smoking is allowed in the house. If smoking in the grounds, in consideration for other users,
please dispose of cigarette butts thoughtfully.
- No hangis or fires are allowed in the grounds or on the adjoining beach.
Please contain fires to the Fire pit which has been specifically designed for this purpose
- Remove all footwear at the door to avoid sand and soil being carried through the house
- Please ensure that the ‘Lock Up Check List’ is carefully checked off when vacating the property
(Copies of the list are near the door into the laundry)
- No tents, awnings or structures are to be erected in the grounds of the property
- No Pets
- No parking on the grassed or planted areas
- Large gatherings of people, over and above the applied for numbers for the stay, are not permitted
- Excess alcohol consumption and loud music is to be discouraged in respect for the property.
- Dry store groceries and supplies not used during a stay are to remain at the house for the benefit
of future users
- Please leave the house in a clean and tidy manner as it was found, including replenishing used
firewood and follow the ‘Lock Up Check List’ provided.
(Bed linen and towels will be washed at the end of the stay by a commercial firm)
Please report any breakages, damage or faults to the administration office of KCT
Ph: 06 759 8940
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