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Disaster Relief Fund Application

Cystic Fibrosis Patient Disaster Relief Program

In light of recent natural disasters, the Boomer Esiason Foundation created a fund that directly assists those families in the cystic fibrosis community affected.

DIRECTIONS FOR APPLYING FOR BEF DISASTER RELIEF:

  • Applicants must complete an official application.
  • A letter from the patient’s social worker/physician stating how much money is needed and where the funds should be allocated. Please specify reasons for relief (i.e. lost items, damages, etc.). The more detail this letter provides, the more attention the evaluation committee will give your application.
  • Please include invoices where applicable.

*Note – grant payment will be made directly to third parties only in a one time payment. Grant allocation conditions may vary.

**BEF reserves the right to request more documentation.

Please email Chris McEwan (disasterrelief@esiason.org) or call 646.292.7939 if you have question about the program or would like to make a donation.

APPLY ONLINE:

Disaster Relief Application

  • Date Format: MM slash DD slash YYYY

  • Additional Documentation

  • Drop files here or
    OTHER WAYS TO SUBMIT YOUR APPLICATION:

     

    You can send the application form in one of three ways:

    Please download and complete the application form:

    Mail the completed form and supplemental materials to:

    Boomer Esiason Foundation
    Attn: Chris McEwan
    200 B Armstrong Road
    Garden City Park, NY 11040

    Email the completed form and supplemental materials to:

    DisasterRelief@esiason.org

    Fax the completed form and supplemental materials to:

    646.292.7945