Apply for Assistance
Please note: Applications without a doctor's stamp will not
be accepted and will be returned to the
This organization was formed to provide financial assistance to those faced with cancer. As we hear of people diagnosed with cancer and undergoing treatments, we do our best to help out with costs such as transportation, fuel, lodging, etc.
In order to comply with government regulations, we are now required to have confirmation/verification that the applicant is undergoing cancer treatments. Therefore documentation is required from the physician in order for payment to be issued.
Please note that all information provided will be kept confidential. The payment will be considered non-taxable income for the recipient.
Forward all required information to us by mail at the above address, and we will do our best to assist you. Application will be delayed if proper information is not provided. Applications are reviewed each month.
PLEASE NOTE: THIS IS A ONE TIME PAYMENT ONLY