Contact Kentucky Elks Association
Kids With Cancer - Online Grant Application
KENTUCKY ELKS ASSOCIATION
“Elks Helping Kids with Cancer”
The mission of the Kentucky Elks State Project, “Jim Bob Kevil” & “Kids with Cancer fund,” is to provide pediatric cancer patients with monetary assistance for travel, food, and medical bills to help families cope with their child’s disease and treatment. This focus is on the values that Elks members support including citizenship, family values, teamwork and responsibility, community and giving, respect, fairness and tolerance. It is the belief that each family will benefit from the “Elks Care, Elks Share” philosophy. In addition to our charitable fund a long-time member from Princeton lodge #1115, Mr. Jim Bob Kevil endowed funds specifically for helping these children & families battling childhood cancer. The “Kids with Cancer” Project shall also provide emergency funds to provide necessary equipment and services, in the absence of an outside funding source, that enable the independence of these patients. It is our hope of the Kentucky Elks Association to help relieve some of the burden that families are experiencing during this time.
The Kentucky Elks Association “Kids with Cancer” Charitable Fund, Inc. is a non-profit 501(c)(3) corporation. Your contribution is fully tax deductible to the extent that current tax law allows.
KENTUCKY ELKS ASSOCIATION
“Jim Bob Kevil” Kids with Cancer”
Financial Assistance Application
Guidelines for Assistance:
Any child under 18 years of age receiving treatment for cancer is eligible for consideration.
The family must be referred by their physician or assigned social worker.
Applicant must be a resident of Kentucky and not reside in a State facility.
Patient application forms must be completed in full. All follow ups or questions regarding the application must be made by the physician or social worker.
All payments will be made directly to vendors. Copy of invoice from the supplier, patient name and cost to the provider, if applies, must be attached to application.
Written verification prepared by a licensed or certified health care practitioner stating that services have been denied via other routes of payment (insurance, etc.) must be provided.
Financial Assistance is provided for:
Doctor, Hospital or Medicine co-pays
Medical Equipment or Supplies
Travel Expenses and Food
Maximum $1000.00 per family per year
However catastrophic expenses above $1000.00 will be evaluated on a quarterly basis and may be covered partially or in full. Because our funds are limited, there is no guarantee we can meet every request, but we will make every effort to provide assistance as we are able.
Complete the following application
E-Mail to: firstname.lastname@example.org
Kentucky Elks Association “Jim Bob Kevil” Kids with Cancer”
Charitable Fund, Inc Application