Beneficiaries & Grants Application Please complete all required fields to apply for cancer research funding. 1. Applicant Information Full Name / Organization Name* Primary Contact Name Mailing Address* City, State, ZIP* Phone Number* Email Address* Website or Social Media Link Preferred Contact Method Select Phone Email Mail 2. Eligibility Information Applicant Type* Select Individual Research Institution Nonprofit Organization Other Primary Focus Area* Cancer Type(s) Relevant to Project Is this a new or existing project?* Select New Existing Previous Funding from This Organization? Yes No 3. Project Details Project Title* Brief Project Summary (250 words max)* Detailed Project Description* Target Audience or Beneficiaries Anticipated Start Date Anticipated End Date Geographic Location of Impact How will the funds be used? Expected Impact 4. Budget Information Total Project Budget Amount Requested from This Grant List of Other Funding Sources Budget Breakdown 5. Supporting Documentation Upload Resume/CV (PDF/DOC) Upload Letters of Support Upload Proof of Nonprofit or Institutional Status 6. Declaration I certify that the information provided is accurate and complete to the best of my knowledge. Submit Application
