If you are looking for assistance please download and fill out this form (Word document download. 309kb) then email it to us.
Please give us two weeks to review the information and we will get back in touch with you.
Survivor Assistance
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I’m writing to thank you guys again for all your support and assistance. DJ had the best x-mas ever and i was able to use the donations, gas cards to get around and take care of some important things. I’m feeling great and doing well emotionally/ physically and can’t wait until doctors release me to return to work. DJ will be turning 4 this Sunday and I still have some of the gifts from you guys saved to give him on his birthday. Today i met with the cancer oncologist and well the verdict is in…. I do need chemo and will be starting cycles hopefully by the end of the month. I was also writing to ask for your assistance again with gas cards for my appointments, and if possible some help with funds. I asked my case manager of any resources or agencies that can help w/ car note or insurance but was unsuccessful in finding any. I’m behind my car payment due to not working and having no income since I went on medical leave Nov. I hope to return to work after port is put in for chemo and receiving first dose of chemo.

– Young Single Mother of a 4 year old