- Created on 16 February 2013
- Last Updated on 24 September 2014
- Published on 16 February 2013
- Written by Administrator
how to apply
Giving is always easier than receiving. It is not easy to ask for help, especially when you are sick. The C.H.A.I.N. Fund wants to help you. We pay the bills that matter the most! Mortgages, Rents, Utilities, and Prescription co-pays. To determine if you qualify for Interim financial assistance, please read our application process carefully.
Note: if you do not have internet access or a printer, please work with a social worker at the medical facility you are receiving treatment at to get access to these forms.
The Funding Committee meets the third week of every month to consider completed applications (note: incomplete files will not be considered). If you qualify and funds are available, We will select the bills that will be paid under the guidelines of The C.H.A.I.N Fund, Inc. Qualified recipients will BE NOTIFIED BY LETTER OR EMAIL.
The C.H.A.I.N. Fund, Inc: Application Process:
PLEASE READ BEFORE FILLING OUT THE APPLICATION
How does The C.H.A.I.N. Fund help?
- Interim is defined as a time period of one month up to 12months*. (*varies based on availability of funds)
- Currently treating is defined as the period after a diagnosis and a surgical procedure has taken place or you are currently undergoing chemotherapy, or radiation. Please note that complications from surgery, are not considered part of current treatment.
The C.H.A.I.N. Fund provides a portion of direct payment of bills such as: mortgages payments, rent payments, utility payments, doctor visit co-pays, and prescription co-payments (for cancer drugs only). The C.H.A.I.N. Fund does not make payments for any medical treatments, insurance deductibles, car payments, car insurances, cable television, internet services, nor cell phones. The C.H.A.I.N. Fund will make direct payments to the recipient’s service providers. No funds are directed to the recipient themselves.
Who does NOT qualify for assistance The C.H.A.I.N. Fund, Inc.?
- You do NOT qualify If you are currently receiving monthly financial aid through:
- The State and/or Social Security Disability programs
- Financial aid, etc. through a local Department of Human Services or Welfare.
- You do NOT qualify if you are retired and receiving a monthly pension check from their former employer.
- You do NOT qualify if your utility bills are currently being paid through a local Low income Home Energy Assistance Program.
Please call us at The C.H.A.I.N. Fund or e-mail us if you have questions or would like help completing the application. If you are unable to print out this application, please email The C.H.A.I.N. Fund to request an application to be mailed to you.
All assistance is made at the sole discretion of The C.H.A.I.N. Fund, Inc.. Each application is given careful, individual consideration, but The C.H.A.I.N. Fund does not guarantee assistance to anyone. Please notice that if you provide incorrect or misleading information on your application, on additional materials, or in any verbal communication with our C.H.A.I.N. Fund representatives,The C.H.A.I.N. Fund reserves the right to suspend immediately any and all current and future funding, and recover all such amounts already paid.
PLEASE NOTE: if you are approved for financial aid and The C.H.A.I.N. Fund writes checks that total over $600, the IRS mandates that a 1099 be issued at year end for this additional miscellaneous income. The C.H.A.I.N. Fund in most cases will not be able to meet all your financial needs while you are undergoing cancer treatment; therefore, we strongly encourage you to explore all other options for assistance during this time.
Please Read Before filling out application:
Please note that is important to make sure that you fill out each and every part of this application. Applications that are not complete will not be processed. This includes the waivers on the back. Please make sure that they are signed and that they also include a witness signature, if one is requested. We would like for you to include in your application a brief paragraph as to what the assistance that we may provide would mean to you and your family. And just how much this assistance can be of a help to you. Please note it is necessary for us to have this information as we are asked to hear from those we have helped and those we are in the process of helping.
The Application process is brief and concise. In order to continue to serve cancer patients we ask that you please make sure everything is filled out, all copies requested are enclosed, and you send in a picture ID (legible copy).
Thank you! We look forward to processing your application and will continue to work diligently to raise the funds needed to assist you in your time of need..