Face The Sun Fund - Assistance

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Apply for assistance
If you are a cancer patient undergoing active treatment, or a family member of someone who is experiencing active treatment, and would like to apply for a Face the Sun "Memory", please tell us a little bit about the patient. Simply fill out the form below, and click the "submit" button after completing the form. (Your email client window may pop up - if so, then just send the form like a regular email.) All information submitted to the administrators of the Face The Sun Fund will be held in the strictest confidence. Please be sure to include your email address on the form, so that Face The Sun can confirm to you that we received your application. If you experience difficulty in submitting the form electronically, you can also print out this page after completing the form and mail to: Face The Sun Foundation, PO Box 23, Oley, PA 19547.	Various Face The Sun "Memories" can include: A family dinner A trip to a local amusement park A sporting event excursion Have an idea for your own Face The Sun memory? Let us know!
Patient first name Last name Gender Age Phone number e-mail address Type of cancer Date of diagnosis Current cancer center(s) at which patient is receiving treatment Name of oncologist Phone number of oncologist or cancer treatment center Current type of cancer treatment (Chemo, radiation, alternative, etc.) Comments? (More info on patients current condition, idea(s) for a Face The Sun Memory, etc.) Please also indicate your name and phone number if you are not the patient for verification needs.

Upon submission of this form you give Face the Sun Full permission to use any names, addresses, phone numbers, etc. for processing use. All information provided in this form will be maintained in strict confidence until the patient gives full right to use such information to the foundation. Our intention upon receiving this form is to contact the patient with-in 48 hours. Please inform the patient that this will occur.

Apply for assistance