Application Process
Cynthia's Breast Cancer
Giving Circle, Inc.

Applications are available July 1 - October 31, 2017

To download an application, please click on the link below or call us to obtain a hard copy at (414) 828-8689.  If assistance is needed with completion of the forms, we are more than willing to help.
501(c)(3) Non-profit Organization (Public Charity)
Step 1

Please read the cover page 1 & 2, which provides instructions and resources.  Complete and return pages 3 & 4 the general information section along with providing copies of all required documents (i.e., current monthly income; monthly statement or receipt or bill of services needed).  Appliciant should be a resident of Southeastern Wisconsin.

Step 2 (Optional - Not Required)

Complete and return page 5 the Personal Statement, which helps us get acquainted and better understand your need for assistance.  In addition, please complete the Publicity Release at the bottom of the page, as well.

Step 3

Complete page 6 and provide the Medical Record Release and Authorization form to your doctorThis authorization gives CBCGC, Inc. permission to obtain information from your doctor pertaining to your cancer treatment ONLY (see Page 7). Submit one copy of this form with the application.

Step 4

Last, have your doctor complete Page 7, the Physician's Statement and return along with all required documents outlined above to our office as soon as possible to:

CBCGC, Inc.
Attn: Review Committee
PO Box 76083
Milwaukee WI  53216.
Review Process:

Once the application has been returned our "Review Committee" will conduct a full analysis of the application.  We estimate the review process will take approximately 3 - 4 weeks and each applicant will be notified by no later than November 30, 2017.  All grant awards will be distributed prior to December 31st each year and a joint order check will be made payable to the grantee and creditor owed. 

Note: We allot 5 business days to obtain missing information from the application.

Record retention is 7 yrs. from the date the application is received.

Anti-Discrimination Policy - click on pdf below.


"A good exercise for the heart is to bend down and help another up."  ~Unknown
"A good exercise for the heart is to bend down and help another up."  ~Unknown
Love & Support
Strength & Courage
"It is more blessed to give than to receive."                                                  ~Acts 20:35



Cynthia's Breast Cancer
Giving Circle, Inc.

501(c)(3) Non-profit Organization (Public Charity)
Love & Support
"It is more blessed to give than to receive."                                                  ~Acts 20:35
Strength & Courage
"A good exercise for the heart is to bend down and help another up."  ~Unknown