Gift Application

Our mission at Sarah’s Fight for Hope is to be able to provide support to as many families of children battling cancer through our various Programs. The Foundation provides custom gifts to kids fighting cancer.

PLEASE READ REQUIREMENTS BEFORE COMPLETING APPLICATION

Download and complete signature page and custom gift detail before completing application

DOWNLOAD FILE

Upload Signature Page required to submit request
New Jersey Residents ONLY
Child is currently in active treatment
Must be between ages 0-19.

WHICH GIFT PROGRAM ARE YOU APPLYING FOR? (Child must be in active treatment)
Please allow 3-4 weeks to complete request

* Indicates required field

Select one: *

Package of Hope (newly diagnosed) Celebrating Hope (inpatient only) Beauty of Hope (MD release)

PATIENT INFORMATION

Child's Name: *

First

Last

Child's DOB (00/00/0000) format *

Child's Gender *

Male Female

PARENT/GUARDIAN INFORMATION

Legal Guardian's Name *

First

Last

Other Legal Guardian's Name *

First

Last

Street Address *

Apartment No. *

City *

State (NJ residents only) *

Zip Code *

Cell/Mobile Number *

Email *

MEDICAL INFORMATION

Child's Diagnosis *

Date of Diagnosis (00/00/0000) format *

Treating Hospital *

Name of Social Worker *

Social Worker's Email Address *

ADDITIONAL FAMILY INFORMATION:

On occasion we like to recognize siblings for supporting their brother/sister during their battle. We know "no one fights alone" and it's important for us that siblings be recognized, and their spirts are lifted as well.

Sibling #1 (use NA if not applicable) *

First

Last

Sibling #1 DOB (use 00/00/000 if not applicable) *

Sibling #2 *

First

Last

Sibling #2 DOB *

Sibling #3 *

First

Last

Sibling #3 DOB *

Thank you for completing your request to brighten a child's day. We will review your request and a notification will be sent to the social worker when it has been approved.

To complete your application please upload the required signature page and gift details below. Please allow 3-4 weeks to complete your request.

Upload File *

Max file size: 20MB

Submit

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CONTACT US
Email: [email protected]
Address: PO Box 578 Long Valley, NJ 07853

IRS Identification Number 82-1733225

Sarah’s Fight for HOPE Foundation is a nonprofit organization committed to providing support to families impacted by childhood cancer.
The Sarah’s Fight for HOPE is a non-profit 501 (c)3 organization. Donations made to Sarah’s Fight for HOPE Foundation are tax deductible in the U.S.

We'd love to hear from you​Questions or comments?

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We'd love to hear from you
Questions or comments?

EXPLORE OUR SITE