HOLIDAY CHEER
SO YOU CAN FOCUS ON HEALTH & FAMILY

Pink Lemonade Project shows holiday cheer with the Holiday Glow program. Holiday Glow is an annual giving program to assist breast cancer patients in the Vancouver, WA and Portland, OR metropolitan areas to have the best possible holiday season. The 2021 Holiday Glow applications are now open. Use the form below to apply for the program.

The application deadline is Friday, December 3, 2021, at 5pm.

Online Application for Assistance through Holiday Glow

PLEASE READ PRIOR TO COMPLETING THE FORM BELOW TO APPLY

Individuals are eligible for 2021 Holiday Glow if they have been in active breast cancer treatment anytime since November 2020. This application must be verified by a breast care provider (physician, social worker and/or nurse navigator). For consideration and review, a clinician’s name, phone number, and email is mandatory. Applicants and care providers will be contacted for more information if selected for Holiday Glow 2021.

The application deadline is Friday, December 3, 2021, at 5pm.

Patient Information

Patient Address(Required)
Preferred method of contact(Required)

Patient Questions

Did you receive any funds from Pink Lemonade Project’s Pink Practicalities during 2021?(Required)

Breast Cancer Provider(s)

Submission Information

MM slash DD slash YYYY
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