Assistance Fund

I Love Alberta Boobs has partnered with the Lloydminster Region Health Foundation to support families in the Lloydminster region as they fight breast cancer. We will be awarding monetary support, quarterly, in order to assist them with the unexpected costs and expenses that occur during treatment. Our goal is to help two families every quarter, but we hope that with community support we can help even more!

Please use the following form to tell us a bit about yourself and family, or the person you wish to nominate. Preference will be given to:

Individuals actively fighting breast cancer
Residents of the Lloydminster and surrounding areas

All information included in the request form will be kept confidential. We may, from time to time, ask for the permission of the families selected to use their name and story for promotional material.

Documentation needs to be provided to ensure individuals are actively fighting breast cancer.

Application Form

Your full name

Your email address

Your city

Your phone number

Who are you nominating? Who are you nominating? Myself Someone else

Full name of nominee

Email of nominee

City of nominee

Phone number of nominee

Describe the nominee's diagnosis and journey.

What would the funds be used for?

How would the funds impact the recipient?

I have documentation to support my diagnosis. *Email must be sent to ilovealbertaboobs@gmail.com, or the application is null* I have documentation to support my diagnosis. *Email must be sent to ilovealbertaboobs@gmail.com, or the application is null* Yes

If you receive this package, may we use the recipient's photo & story to help others? (this will not impact whether a recipient is considered or not) If you receive this package, may we use the recipient's photo & story to help others? (this will not impact whether a recipient is considered or not) Yes No

Assistance Fund

Assistance Fund

Application Form

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