Apply for Aid - Sweep Away Cancer

Fighting Cancer or Know Someone Who Is? Apply for Financial Assistance

Our goal is to help cancer patients well-being by limiting financial challenges associated with a diagnosis. We want to make sure that our donors’ extremely generous donations get to the people who really need our help the most.

If you know of someone who could use our help, please fill out this application and someone from our board will reach out to you within two weeks.

Your Information
Name*
First Last
Phone*
Email*
Relationship to person needing assistance:*
Information on Person Needing Assistance
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Gifts will be given on a one-time basis up to $5000
Is the individual applying for aid involved in the chimney/hearth industry, a veteran, a first responder or active duty?*
- Yes
- No
Please provide details of their involvement in the industry*
Diagnosis:*
Please provide us with a brief history of the applicant and the diagnosis.
Why you feel they would benefit from Sweep Away Cancer:*
Other information you feel we should know:
How did you hear about us?
Name
This field is for validation purposes and should be left unchanged.

How Can You Help?

Sweep Away Cancer is not funded by the government or a gigantic foundation. It’s funded almost entirely by people just like you, many of whom have been touched by cancer. We’re caring individuals and small business owners who want to make a difference in the lives of those living with cancer.

Looking for ways to help? We have lots of great ways to join the movement.

When you contact us, you can count on a welcoming response from Sweep Away Cancer.

Fighting Cancer or Know Someone Who Is? Apply for Financial Assistance

Your Information

Information on Person Needing Assistance

Gifts will be given on a one-time basis up to $5000

How Can You Help?