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Financial assistance is provided to any breast cancer survivor in active treatment. 

Application Submission Process
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Qualifying applicants can receive up to $250 in financial assistance

for ONE of the following: 

  • Utilities: Electric, Gas, Water  

  • Housing: Rent or Mortgage  

  • Medical Co-Pays or Prescriptions

​

Only complete applications will be processed. *Incomplete applications will not be reviewed or processed.  Please allow up to 30-45 days for review and processing.
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If approved, payments will be made directly to the Third-Party Provided

*Submission of this application does not guarantee approval of receiving financial assistance. *

Upload ALL required documents (medical verification and one bill (utility bill, lease agreement, mortgage statement)

Breast Cancer Assistance Application

Personal Information

Birthday
Month
Day
Year
Multi-line address

Race/ Ethnicity

Choose One
Black / African American
Hispanic / Latino
White
Asian
American Indian
Other

You MUST BE currently in treatment to receive assistance.

Currently In Treatment
Yes
No

Payment:

All payments will be mailed directly to the third-party / provider. 

No payments will be sent to applicants.

Qualifying applicants can receive up to $250 in financial assistance for the following: 

  • Utilities: Electric, Gas, Water  

  • Housing: Rent or Mortgage  

  • Medical Co-Pays or Prescriptions

Assistance Requested: *pick one

Assistance Needed
Are you employed?
Yes
No
If yes, Occupation. If no, Why?
Do you have medical insurance?
Yes
No

Submit Proof of items listed below that will assist our Krew in making a decision.

*Current utility bill, mortgage statement or full copy of lease agreement (applicant name must be listed)

  • Please submit only one bill

**Copy of current treatment plan (on letterhead, signed and dated) verifying diagnosis and detailing treatment plan from one of the following: (Oncologist, Licensed Social Worker, Nurse Navigator or Patient Navigator)

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© 2026 by Kena's Krew Foundation. Powered and secured by DannaMc INK. 

KENA'S KREW FOUNDATION | PH: 346.673.2500

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