Enrollment

 

QUALIFYING REQUIREMENTS FOR OUR PROGRAM

  • Child must be under the age of 21 years old
  • Child's diagnosis must be a brain tumor, spinal cord tumor or childhood cancer
  • Custodial Parent/Guardian must be a US citizen
  • Custodial Parent/Guardian must be a Wyoming resident
  • Custodial Parent/Guardian must provide a Wyoming Driver's License

 

ENROLL IN OUR PROGRAM

You may email, fax or mail the form to Jason's Friends Foundation. Please print form below:

Family Enrollment Form

A copy of your driver's license is required.

Email: info@jasonsfriends.org

Mail:

Jason's Friends Foundation
340 West B Street, Suite 101
Casper, WY 82601

Fax: (307) 265-4668

Telephone: (307) 235-3421

Please note: Direct referrals that do not come from the hospital social worker require a written diagnosis from the hospital/doctor. 

 

FORMS FOR FAMILIES ALREADY ENROLLED

Travel Reimbursement Form

Household Bills Payment Request Form