TruFund Family Support Application

TruFund provides practical financial support to families in the Coachella Valley, California, who have a child in active cancer treatment. Assistance may include gift cards, travel expenses, lodging assistance, and other urgent needs related to treatment and care. Our goal is to help ease the financial impact of treatment so families can focus on what matters most: their child and their family.

Current Eligibility Requirements:

• The child must be 18 years old or younger.
• The child must be in active cancer treatment.
• The family must reside in or be receiving treatment within the Coachella Valley.
• Additional eligibility requirements may apply.

Confidentiality Notice: All information provided through this form is kept confidential and used solely to evaluate assistance requests. Information will not be shared outside of the TruLiving Foundation without your permission, except as required by law.

Parent/Guardian Name

Child’s Name

Child's Date of Birth

MonthDayYear

Please provide basic information about your family and child. This information helps us connect with you, understand your family's needs, and determine eligibility for assistance. All information is kept confidential and handled with care.

Home Address

Phone Number

Email Address

Preferred method of contact (call, text, email)

Child’s Diagnosis

Date of Diagnosis

MonthDayYear

Treatment Facility/Hospital

Treating Physician or Care Team (Optional)

What type of support are you requesting?

Please tell us about your current situation and how TruFund support would help your family right now.

If requesting financial assistance, please provide an estimated amount needed, if known.

Required Checkbox #1

Required Checkbox #2

Required Checkbox #3

TruFund Family Support Application

Personal Information

Diagnosis Information

TruFund Support