Breast Cancer Assistance Program

BREAST CANCER ASSISTANCE PROGRAM (BCAP) APPLICATION

Dear Applicant:

The Breast Cancer Assistance Program (BCAP) provides assistance to women facing financial challenges after diagnosis. This program provides free mammograms and financial support for: medical related lodging, co-pay, office visits, prescriptions and transportation.

The form below must be completed and submitted with the REQUIRED SUPPORTING DOCUMENTS (i.e., medical bills, rent receipt, utility bill, etc.). Upon completion and submission of the form, the application process takes a minimum of 7 business days, incomplete application will be returned and will delay any decision regarding assistance.

If your application is approved you are required to do the following:

    • Submit a statement of testimony to SNI which may be posted on our website within 2 weeks or sent to funders
    • *Contact your local Sisters Network Chapter and become an active or associate member. *If a chapter is located in your area.

If these requirements are not met you will be ineligible to apply for future funding.

It is our goal to assist you financially during your journey. Sisters Network® Inc. (SNI) is a leading voice and only national African American breast cancer survivorship organization in the United States. Our purpose is to save lives and provide a broader scope of knowledge that addresses the breast cancer survivorship crisis affecting African American women around the country.

Wellness,

Valarie C. Worthy, President Sisters Network Triangle NC