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Request for Assistance Application

The Well Yeah Ariel Roberts Foundation can help provide financial assistance by paying bills and expenses for qualified recipients. Qualifying bills and expenses include rent or mortgage, home utilities, and vehicle payments. We can assist up to $2,000.

Those who wish to apply for financial assistance must complete and electronically submit the application form below.

Requirements for Assistance

  • Must have a pediatric cancer diagnosis

  • Ages 0-20 years old​

  • Provide the basic information requested on the form

  • Applicants must reside in Indiana​​​​​​

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