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Just-In Time Grant Application


  • Grants available to all ages

  • Applicant or a dependent has a cancer diagnosis and is receiving active treatment

  • Must be experiencing financial hardship

  • Must be living in or treated in Minnesota

Please select one of the following options:

Applicant Information

Patient Information

If different from applicant (otherwise leave blank)

May we leave a message on your phone?
Inform me regarding my application via:

Medical Information

Household Information

Financial Information

What is your current housing situation?

Additional Information

I declare that the information on this application is true and correct to the best of my knowledge. I understand that all applications will be reviewed on a case-by-case basis and final determination will be made by Justin Kukowoski Foundation. I hereby give my permission that this application and all information provided can be sent to Justin Kukowski Foundation and discussed with my health care professional. All information reviewed is confidential.

How did you hear about the Just-In Time Grant?

Thank you for your application! We will be in contact with you soon.

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