Lump to Laughter, Inc

Angel Fund Request

Applicant's Contact and Personal Information

* Today's Date

* First Name

* Last Name

If you are completing this request on behalf of the applicant, do you have their permission to do so?

If you are completing this request on behalf of the applicant, please provide your name, organization and contact information

If you are completing this form on behalf of someone who does not have an email, please use THEIR firstnamelastname@NOMAIL.com
Using your email will result in your data in our system overriding what you enter. Thank you.

* Email

* Address

* City

* State

* Postal Code

Below are the ONLY Counties in NC that we offer our Angel Fund Grants.

* What County do you reside in?

* Phone

* Date of Birth

Race/Ethnicity

* Date of Breast/Ovarian Cancer Diagnosis

Age at Diagnosis

* What active treatment(s) are you currently in?

* Where are you receiving treatment and who are your doctors?

* Please explain in detail about your need and current situation prompting you to apply

* What is your total combined annual income?

* Are you currently working?

If you answered No to the above, what is your source of income currently?

* Number of members living in your household

* Who is living in the household with you currently? (If adults, please indicate their contribution to the household and if children, please indicate their ages)

* Have you applied for any other assistance?

If you answered yes to the above, please explain where you have applied and if you have received assistance, please indicate what you received.

* Stage of Breast/Ovarian Cancer

* Type of Ovarian/Breast Cancer

* How did you hear about the Angel Fund?

You can scan all required documents in as one attachment using the Upload Document link below.

Document

If you are requesting assistance with a utility/phone bill, car payment, rent/mortgage; please upload the monthly statement/bill and/or lease agreement. We will need these documents in order to make payments if your request is granted.

Other

Optional: Upload a photo of yourself

Photo

Angel Fund Request

The Angel Fund provides financial assistance to women in true immediate need, while undergoing active treatment of Breast or Ovarian Cancer in Southeastern NC.

Assistance is for necessary household expenses or child care related expenses like rent/mortgage, car payment, utility bills, gas or grocery gift cards, day care or child extracurricular activities.

The following documents are required to process your request:

*Pathology report or written statement on letterhead from your doctor indicating your diagnosis date and confirming you are in active treatment for breast cancer.

*Two letters of reference attesting to your need.

*Copy of a government-issued ID.

*Most recent tax return.

*Most recent pay voucher or proof of income.

*Statement of your household expenses.

Please complete all of the required fields in the Angel Fund Application and upload all requested documentation. You can also mail or fax the documents to: Lump to Laughter, PO Box 1295, Wrightsville Beach, NC 28480. Fax 910-679-4452.

If you need assistance with the application please feel free to email us at: AngelFund@LumptoLaughter.org

We would like to thank The Landfall Foundation for their continued grant support for home preservation for single-parent families in New Hanover, Pender and Brunswick Counties. 2022 $5500, 2021 $7500, 2020 $7500, 2019 $6000, 2018 $6000, 2017 $3500. We are so grateful.

Other resources & supportive organizations that can assist you are available on the document attached below.

Downloads

Other Resources

Supportive Organizations

Lump to Laughter, Inc

Angel Fund Request

Applicant's Contact and Personal Information

Below are the ONLY Counties in NC that we offer our Angel Fund Grants.

You can scan all required documents in as one attachment using the Upload Document link below.

If you are requesting assistance with a utility/phone bill, car payment, rent/mortgage; please upload the monthly statement/bill and/or lease agreement. We will need these documents in order to make payments if your request is granted.

Optional: Upload a photo of yourself

Angel Fund Request

Downloads

Other Resources

Coverage Area in Southeastern NC