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The application MUST be signed by the applicant AND their health care professional.

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IMPORTANT: Health care professional's contact information should be clearly written and include a phone number and email address. To avoid delays in the application process, we strongly recommend that you select a readily contactable health care professional (preferably a social worker or nurse). NOTE: Your application will not be processed without confirmation from a health care professional.

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1. A letter of intent*. It should:

   • Explain your need for financial assistance. ​

   • Address the financial impact your diagnosis has had on you (and your family, if applicable).

   • Identify precisely how these funds would be used. 

   • Indicate the amount requested. 

2. A copy of your Notice of Assessment from the last fiscal year. (all four pages)

3. If applicable, include the following documents:

• A copy of your spouse's Notice of Assessment from the last fiscal year. (all four pages)

• Copies of birth certificates for all children under the age of 18. 

• Only if on sick leave: Proof of employment income in the year prior to breast cancer diagnosis (eg., last pay stub, recent proof of salary or disability insurance or employment insurance)

*Letters of support written by your healthcare professional in addition to your letter of intent is welcome and should be sent directly from your healthcare provider.