Application for Assistance

Let us therefore come boldly unto the throne of grace, that we may obtain mercy, and find grace to help in the time of need. Hebrews 4:16

Please file out the following form with requested information to apply for Aid.

In addition to this form anyone wishing to receive aid from the C. Wright Project will be required to provide the following documents.

  • Letter from you Oncologist, a licensed social worker, or case worker on letterhead verifying your current diagnosis and treatment plan
  • A copy of your driver’s license or valid state ID card
  • Your most recent pay-stub
  • A copy of all bills you wish considered for payment

Documents may be faxed to 318-747-3862 or emailed to

Be sure and complete the entire form before submission.

After completing this form and the submission of the required documents above, you will be contacted for the next step in the application process.

Fields marked with an * are required