Application for Financial Assistance

Apps for Financial Assistance

Application for Financial Assistance

The Do More Foundation exists to assist families with financial needs as a result of the death or illness of a child.
  • Mother's Personal Information

  • Please enter a value between 1 and 25.
  • Father's Personal Information

  • Please enter a value between 1 and 25.
  • Information Related to Child's Diagnosis and Treatment

  • Grant Request Information

  • Income Information

  • As a part of our funding process, we are required to verify income for all applicants. Please attach a copy of the first page of the most current 1040 federal tax return form and/or SSI as well as SSDI statements. Be sure to include the entire gross annual household income from all sources combined. For each subsequent request, forms must be updated and re-certified.
    Drop files here or
  • Application Agreement

    I hereby apply for assistance from The Do More Foundation to assist with expenses related to the chronic illness of my child. I attest that the information contained in this application is true and accurate. I authorize The Do More Foundation to obtain information from our my Doctors or employer to verify the information above that is pertinent to the application and grant request. I understand that any information that is falsely submitted will disqualify me from receiving financial assistance from The Do More Foundation.
  • Media Release

    I hereby authorize The Do More Foundation, Inc. to use my photographs, letters or information in publications or on the Internet. I understand that these items will be used to educate the public about The Do More Foundation, Inc. and its services. I further understand that our last name will not be used in any material. The consents, terms and conditions of this agreement shall continue in effect beyond the date it is signed.
  • Application Requirements

    • Please complete all areas on the application.
    • Make sure you have included the name and phone number of the Physician and Social Worker.
    • Please submit a current picture of the child with the application and history form filled out.
  • This field is for validation purposes and should be left unchanged.