Aid Application

If you are unable to pay your bills due to your cancer please download our aid application. The application is available as either a Word document or a PDF document. Click on the link below to download the format you prefer.

Aid Application as a Word document
Aid Application as a PDF document

Both formats contain the same 17 page application. Make sure it is complete with your last income tax statement and a letter from your doctor stating your current condition. Be very accurate and complete with all sources of income as well as all your expenses. Do your best to print neatly which helps us.

After review of your application we will call and interview you and then make a decision as to how we are going to help, We help in blocks of three months and evaluate at the end of each three months. Our goal is to take away some of your financial worries so you can focus on getting better healthwise.

We like to think we offer you hope and this lets you know that you are not alone in your battle with cancer. Good luck and use the below form to attach your application or send in your application today to the address listed below the form.

OR Send your completed application to:

Vickie's Angel Walk
P.O. Box 174
New Cumberland, PA 17070