Help Now Fund 2019 Application

READ ALL BEFORE CONTINUING TO THE APPLICATION

Please note the application process takes on average 1 to 2 hours to complete. Please review all important details before beginning the application process as it is unable to save for privacy purposes. 

The Help Now is a program for breast cancer patients, providing financial assistance for rent or mortgage, utility bills, cell phone bills, and car payments. All qualifying applications will be submitted to the committee and considered for aid.

Consideration and/or Submission DOES NOT GUARANTEE funding. Due to limited funds, eligible applicants are NOT guaranteed approval. Please understand this is a highly competitive application process. It is up to the applicant or applicant representative to follow all required steps of the application process. BCCA is unable to notify an applicant if the application is incomplete. 

Before you begin please review all the FAQs, video, and required documentation. Applicants who do not submit all required documentation, in a clear, readable format, WILL NOT BE NOTIFIED that their application is incomplete.

To be considered the Applicant must:
1. Provide a copy of valid U.S. issued identification
2. Provide current (within 90 days) copies of bills and/or rental agreement, if the lease is out of date please provide us with a renewal letter. All documents must be clear where the committee can confirm the name, account number, and amount due on the bill. Screenshots or incomplete photos of bills will not be considered. All bills need to have the company name, account holder's name and address, and amount due.
3. Provide the first two pages of your most recent tax return document. This is required to expedite the grant process and comply with Federal tax auditing guidelines. If you do not file taxes, proof of SSI/Disability suffice.
4. Provide a current (within 90 days) letter of treatment/diagnosis from a medical professional. This letter must be on professional letter head and include the patient's name, date, and medical professional signature. Diagnostic reports, appointment reminders, and release forms will not be considered. 
5. Must be a U.S. Citizen or Legal U.S. Resident. All Legal Residents must attach a copy of their residence card as well as valid government issued ID.
6. The applicant may not have received funding from The Help Now Fund within the last calendar year (January 2019 through December 2019) 
7. Applicants, please provide the Medical Release Agreement to YOUR medical professional listed on the application. Medical Release Agreements can be found here
8. Applicants, please provide the Billing Release Agreement to YOUR utility company, mortgage company, and/or leasing agency. Billing Release Agreements can be found here

Disclaimer:

DO NOT attach either the Medical or Billing Release to your application. These documents allow BCCA to retrieve basic information regarding treatment and billing. However, both are needed to complete the application selection process. Please provide these documents to the correct medical professional or company. If the applicant does not give the Medical or Billing Release documents to the appropriate party, the application may not be considered for funding. 

Sorry, but this form is no longer accepting submissions.

Thank you for inquiring about the help now fund, applications are open and accepted the first through the fifth of every month only. If you are inquiring about the status of an application, someone will be in touch with you by the 15th of every month with an update. Decisions will not be made until the 15th of every month. For more questions please email helpnow@IGoPink.org