Apply for the Nancy Falco Fund 2016

Eligibility Criteria

  • Applicant must be a current Georgia resident.
  • Applicant must have a current cancer diagnosis; may be undergoing treatment or recently completed chemotherapy and/or radiation.
  • Application requirements must be completed by the applicant or an immediate family member.
  • Applicant must submit completed application along with supporting documentation no later than 8/5/16. Fax all documents to 866-214-4722
  • Application must include proof of relationship such as Birth Certificate, Marriage license or Power of Attorney. Please note that proof of relationship is only needed if someone other than the person with cancer is filling out the application.

Fax all documents to 866-214-4722
Fax all documents to 866-214-4722
Fax all documents to 866-214-4722
Including but not limited to medical expenses, notice of loss of income due to illness

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© 2017 Dancers Unite Against Cancer | Nancy Falco Fund Limited is a 501(c)(3) Non-profit organization