Assistance Request Form

The Stronger Together Foundation provides financial support to individuals and families facing cancer in Dickey and LaMoure Counties.

You may complete this form if:

• You are a resident of Dickey or LaMoure County who has been diagnosed with cancer, or

• You are nominating someone from Dickey or LaMoure County who is currently facing cancer.

To receive support, please submit proof of a cancer diagnosis — such as a doctor’s note or an appointment card — along with your application. Verification is required to ensure IRS compliance and preserve our tax-exempt status.

Please fill out the form below to apply. Our team will carefully review each request and follow up with you directly.

Please note each individual may be nominated up to four times per calendar year.