A financial assistance grant for those experiencing GBM brain cancer.

A diagnosis of Glioblastoma can be very expensive.  From healthcare to adapting your home to changes in employment to caregiving, these expenses can add up quickly.  Our goal here at Kelli's Kegs N Eggs 5k is to help out families that have encountered the struggle of Glioblastoma and financial hardship.  As part of our process to approve your request, please fill out the form below and answer all questions fully and specifically.  You may nominate an individual or apply as yourself.

1. Fill out the form below

2. If apply on behalf of an individual, please fill out form to the best of your ability. We will contact you if we are in need of more information.

3. This form requires financial information in order to determine the grant amounts

By applying for this program, I understand:

1. You, or the individual nominated, resides in Indiana.

2. Applying gives Kelli's Kegs N Eggs 5k authorization to utilize quotes, stories, and images supplied as part of an application process to further help our goal or reaching more families affected by Glioblastoma and the challenges Glioblastoma presents.  This information may appear in various mediums and applications but is not limited to the foundation website, social media pages, print or digitally at events or during presentations, and in marketing materials made available to the public.  However, we will never share personal contact information publicly.

3. To reach as many people as possible and to spread our giving, this program is only available as a one-time grant regardless of changes in diagnosis or extenuating circumstances.

4. Grant awards are payable by check to the awardee.  They may be taxable to the full extent by the United States Federal Government and your state and local statutes.

5. Submission of this application permits Kelli's Kegs N Eggs 5k's team to review my application and provide applicable social media.  It may also include reviewing public documents as they work diligently to determine the need and award a limited number of grants to many applicants.  At no time will your personal information be submitted for a formal background check or submitted to any third-party review organization.

6. Applying allows Kelli's Kegs N Eggs 5k to request additional information to best award applicants their award, if necessary.

7. All applications are reviewed by the board before funds are distributed.  You will be contacted by a member of our team if we need further information or documentation and if you have been selected as an award recipient.