Criteria Of An Applicant
Applicant must be 18 years of age or younger experiencing a medical or living emergency. Applicant must reside in one of the following locations:
Staten Island, NY • Bergen County, NJ • Essex County, NJ • Hudson County, NJ • Middlesex County, NJ • Monmouth County, NJ • Ocean County, NJ • Union County, NJ
Fill Out Our Application Online Or Download And Complete Offline
In order to complete the application online you will need to provide/upload the following documents:
- Drivers License/Photo ID
- Letter from a physician(s) confirming diagnosis
- Copies of Invoices for payment (if applicable)
- Copy of 1st page of bank statement (if applicable)
Online Grant Application
To fill out our grant application online please click the button below to be taken to our online form.
If you prefer to download our application please click the buton below to download our form.
Years of Service
Frequently Asked Questions:
Who Can Apply For Assistance?
How Long Does The Process Take?
How Can I Check The Status On a Grant Application?
We will contact you once we have received and reviewed your request. You can also call our office at (718) 967-9085