Heartland Cancer Foundation
  • Apply
    • Eligibility
    • Online Application
    • Download Application
  • Donate
  • Get Involved
    • Planned Giving
    • Fundraise
    • Volunteer
  • Sponsor
  • Events
    • Mardi Gras Gala
    • Oncology Symposium
    • Heartland Golf Classic
  • Resources
  • Vlog
  • About
    • Our Story
    • Board of Directors
    • Impact Guild
  • Contact

Download Application


​Patient or providers must print the application and mail the completed application with income verification documents to the foundation office. Heartland Cancer Foundation will review the application on a rolling deadline to approve or decline your submission. Once a determination has been made, you will be notified by mail. Please make sure you have read and understand the Grant Restrictions, HIPAA, and Income Requirements.

To be eligible you must meet the Income Requirements and reside in Nebraska in one of the currently eligible counties. For the most up-to-date list, visit the eligibility page. Residents of other counties in Nebraska may still apply based on financial need, and grants will be considered based on available funds.
Download Application
©2025 Heartland Cancer Foundation. All rights reserved. Unauthorized use prohibited. 
​Heartland Cancer Foundation is a qualified 501(c)(3) tax-exempt organization.


  • Apply
    • Eligibility
    • Online Application
    • Download Application
  • Donate
  • Get Involved
    • Planned Giving
    • Fundraise
    • Volunteer
  • Sponsor
  • Events
    • Mardi Gras Gala
    • Oncology Symposium
    • Heartland Golf Classic
  • Resources
  • Vlog
  • About
    • Our Story
    • Board of Directors
    • Impact Guild
  • Contact