Please click on the 'Application for Assistance' space below. This will allow you to download or print out a copy of the application.

If you are not able to do so, please contact Jen's Friends at 603-356-5083 and an application will be sent to you.

The patient, a family member or a friend can fill out an application. If you are having difficulty filling out the application, a member of Jen's Friends will assist you. Applications should be sent to:

Jen's Friends Cancer Foundation
PO Box 1842
N. Conway, NH 03860

Click Here For A Copy: APPLICATION FOR ASSISTANCE