Randi Friedman Wellness Grant Application
Mail to: Boston Cancer Support  831 Beacon Street #107, Newton, MA 02459

Click here to apply online

Randi Friedman Wellness Grant Application
Mail to: Boston Cancer Support  831 Beacon Street #107, Newton, MA 02459

Click here to apply online

The Randi Friedman Wellness Grants:
3 month Yoga membership (Anywhere in MA)
3 month Pilates membership (Anywhere in MA)
3 month Meditation class membership (Anywhere in MA)
8 week Stress Management & Resiliency Training Program (Newton Location)

Apply for one of 4 grants by filling out the form below for you or a loved one.
Recipients of the 2019 Randi Friedman Wellness Grants will be notified by
January 30, 2019. Recipients must be either a cancer survivor, or currently
in treatment with physician approval.

 

Name:

 

First_________________________________  Last_________________________________

 

Email________________________________  Phone________________________________

 

Street Address_______________________________________________________________

 

City__________________________________ Zip Code______________________________

 

Birth Date_____________________________

 

I am applying for:

________ 3 Month Yoga Membership

________ 3 Month Pilates Membership

________ 3 Month Meditation Class

________ 8 Week Stress Management & Resiliency Class  (Newton Location)

 

_____I am applying for myself

_____I am applying for a friend/family member

If this application is for a friend / family member, in what city / town do they live?

_______________________________________________________

Please share below, how this wellness class would be helpful and why. Feel free to also use other side of this sheet: