By signing below, I confirm that the information provided above is accurate, and that I understand this application is for consideration of financial assistance from The Ohio Valley Fighting Cancer Fund. I consent to the review of this information, and its full use in determining my eligibility and coordination of payments and assistance as necessary. I understand utility payments can only be made after providing a current copy of the bill itself and that no cash is given directly to applicants. Applicants will be limited to up to $1,000 dollars of total assistance annually subject to the discretion of the board and based upon current funds available to benefit as many families as possible fighting this horrible disease. We pray that this fund will be a blessing to you and your family during this time and for the full recovery and healing of your loved ones ~ In Jesus’ name

Call Tambi (740) 424-1934 or Galen (740) 591-8079 for more information.