Application

Apply

Apply

For Applicants

If you or someone you know would like to apply for a grant from the AGSS Memorial Foundation, please see the directions.

STEP #01

Fill out the Andrea’s Foundation Grant Application either in print or digitally. Make sure that the application is signed by the patient. DIGITAL SIGNATURES ARE NOT ALLOWED BY LAW.

STEP #02

BY EMAIL: Send a scan of your application to info@agssmemorialfoundation.org BY FAX: Fax your application to 805-477-9814 BY MAIL: Send a copy of your application to AGSS Memorial Foundation 1746-F South Victoria Ave. #245 Ventura, CA 93003

Note: Please download the form using the button below, print it, fill it out, and upload the completed form using the submission form provided below. Do

STEP #03

Response time averages 1-2 weeks

Complete Your Form

If you or someone you know would like to apply for a grant from the AGSS Memorial Foundation, please see the directions below.

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Fill out the Andrea’s Foundation Grant Application either in print or digitally. Make sure that the application is signed by the patient. DIGITAL SIGNATURES ARE NOT ALLOWED BY LAW.

number11

Send in the application
send a scan of your application to info@agssmemorialfoundation.org
BY MAIL: send a copy of your application to AGSS Memorial Foundation1746-F South Victoria Ave. #245 Ventura, CA 93003

number12

Response time averages 1-2 weeks

Process Timeline

We Receive Your Application

Verification of need.Our team contacts your medical provider (and nursenavigator, if applicable) to confirm need, treatment, and diagnosis.

Our board of directors reviews applicant need profile, recommended donation amounts, and votes.

If approved, a check is sent to the grant applicant via mail.

Local & National Resources

A list of local and national resources available for cancer patients and their families.

Verification

Verification of need. Our team contacts your medical provider (and nurse navigator, if applicable) to confirm need, treatment, and diagnosis.

First Step

Review

We review your submitted form to begin the verification process.

Second Step

Confirmation

If approved, a check is sent to the grant applicant via mail.

Final Step

Who we serve