Notice: Undefined index: options in /home2/wsvlester/public_html/wp-content/plugins/elementor-pro/modules/theme-builder/widgets/site-logo.php on line 192

Request Assistance

We realize families with sick kiddos are overwhelmed with forms at the hospitals and doctors’ offices. We do not want to be an additional burden of paperwork. If you wish to speak to one of our board members about receiving assistance, please provide your contact information below. We will contact you to discuss assistance and keep paperwork to a minimum.

BEFORE YOU APPLY, PLEASE READ THESE IMPORTANT NOTES:

1.) We are a 100% volunteer organization. With the volume of requests we receive every day, it sometimes takes a little bit of time to get back with applicants. Sending multiple emails and voicemails will slow the process down for everyone.

2.) To receive assistance from our foundation, you must have a child or dependent that has a condition that prohibits you from working or creates a temporary loss of income (example: unpaid leave, part time, reduced hours, FMLA)

3.) Our bylaws state that we can only pay bills on behalf of families. So, when filling out your application and request assistance, please make sure what you are asking for can be paid by a 3rd party. Asking for food money or gas money is very difficult for us to consider.

Address(Required)
Please provide an explanation of your financial burden related to the extended care of the child and work status.
Drop files here or
Max. file size: 2 MB, Max. files: 3.