Breast Wishes Fund

CHOICES FOR BREAST CANCER TREATMENT AND PREVENTION


Uninsured Treatment Fund

The mission of Breast Wishes is to “Give US Choices” for Breast Cancer Treatment and Prevention. The Uninsured Treatment Fund offers clients a financial grant for their uninsured choices to work with their active cancer or recent diagnosis.

Application
Clients complete the following application for the breast cancer treatment they would like to utilize that is not covered by insurance and why. Included in the proposal is their diagnosis and treatment history to date, itemized details of their chosen treatment and costs as well as applicants financial need history preferably their tax return from the last year. Applicants are required to document and share their healing methods with Breast Wishes audience via website, newsletters, social media and events. Methods for this may be blogging with hyperlinks that includes scientific data, photos and edited video no longer than 90 seconds per clip, art and music. Grants must be used within six months of issue and only used for treatment, not daily expenses such as rent, utilities, etc…

The Board of Directors will choose recipients based on the applicants financials, type of treatment they desire, how much it will cost and ideas for sharing their experience with Breast Wishes audience.

Ways to Give
The first grantee received a challenge grant from a Breast Wishes Board member who offered to pay for half of her personalized cancer vaccine. Grantee’s may increase their tax deductible donations by campaigning friends, etc, by clicking Breast Wishes GIVE button on www.breastwishesfund.org and designating gifts in grantees name in the drop down menu of the Uninsured Treatment Fund. Breast Wishes is currently seeking grantors and private foundation funds to contribute to the Uninsured Treatment Fund.

Uninsured Treatment Fund Application
Name:
Phone:
Email:
Occupation:
Amount of grant request:
1-The mission of Breast Wishes is to “Give US Choices” for Breast Cancer Treatment and Prevention. How does your cancer experience mirror this viewpoint? How will you support Breast Wishes and their clients now and in the future?

2-Date, details of diagnosis and cancer treatment so far:

3-What uninsured cancer treatment would you use this grant for? Cost of treatment? Why do you feel this method of healing will be effective for your cancer? Please itemize the costs and dates of your treatment and provide scientific or other data to support your treatment choice.

4-How do you propose to share your healing experience with Breast Wishes audience on their website, social media and events? Do you have writing, researching, social media and/or computer skills? Other skills you would consider volunteering? Please explain.

DISCLAIMER-If chosen for this grant, Breast Wishes Fund is in no way liable for the sickness or death of applicant. Please print and sign your name here

_____________________________________print

_____________________________________signature _____________date

Please include your tax returns from last year or other financials that prove your need. Submit completed application to lexie@breastwishesfund.org