Support for Patients and Caregivers

EIA Grant Details

About the Grant

Application Checklist

Empathy in Action provides grants for tangible assistance (i.e., goods, services and/or funds) to brain tumor patients and caregivers in accordance with our charitable purposes. Awarding of grants shall be based on determination of financial need.

Patients whose annual household income exceeds 300% of the Federal Poverty Guidelines are ineligible for assistance under this program.

Grants up to $1000 will be awarded. No more than one grant will be issued to the same household.

Application Checklist

**Incomplete applications will not be considered**

MUST include the following:

1. Signed application

2. Signed consent form

3. Copy of driver’s license or state identification

4. Copies of all income sources

5. Copies of all current bills/creditor statements

6. Copies of the most current bank statements – 3 months

7. Confirmed diagnosis and treatment by Nurse Navigator/Social Worker

Please send completed application and consent form to Winks from GOD!, P.O. Box 5186, Suffolk, VA 23435 or email to support@winksfromgod.org.

Empathy in Action (EIA)

EIA Grant Details

About the Grant

Application Checklist

Application Checklist

Application Checklist

Application Checklist

Application Checklist

Application Due Date