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Charity Volunteers
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Ask for Assistance

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Ask for Assistance

APPLICATION PROCESS:

  1. Complete each section of the application.

  2. Ensure all supporting documents are submitted with the application.

  3. Verify that your diagnosis falls under the listed illnesses.

  4. The review process may take 2-3 business days. Once completed, you will receive a "Notice of Action" email.

  5. Please read the application carefully. Answer each question completely with printed or typed responses. If more space is needed, attach an additional sheet. Incomplete answers or missing verifications may delay processing or result in a denied application.

  6. Submit all required documentation within 30 days of receiving a completed application (completed, signed, and dated). Please note that applicants may only apply every six months.

 

Term and Conditions

Requirements

Apply Here

Additional Information

Choose illness:
Choose illness:
Choose illness:
Upload File
Upload File
Upload File

Assistance Requested

Assistance Requested: Please place the amount next to each type of assistance requested, if known.

Employment Information

A. Is applicant currently employed?
If unemployed, has applicant registered with the Career Center?
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