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Apply for Assistance

If you or a loved one is in need of assistance, please download and complete the form below.  All forms should be sent to

The form is available as a PDF document that can be printed and completed or a word form document that can be filled out electronically.

Past Recipients


Zoe Davis



A 2 year old princess fighting leukemia

Sophia Viveiros



A 3 year old super girl battling cancer

Henry Ouellette



A 6 year old Resilient little fighter

battling leukemia

Finn Paradis


#ForcaFin / #FinnsFiercefight

A 3 year old warrior battling cancer

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