Application for Assistance

Please have the following documents ready as they are required to process the application:

  • Copy of valid drivers license/photo ID

  • To be considered for financial assistance, you must be a resident of Palm Beach County, Martin County or St. Lucie County

  • Proof of household income. This includes income for everyone 21 years of age or older living in the household who is working. Copies of the last two (2) month’s bank statement for all banks of all individuals, 21 years of age or older living in the household

  • Copies of your most recently filed tax return and W-2 statement

  • Current and complete copies of all monthly expenses

  • Signed ‘Physician’s Statement’ which can be downloaded HERE

  • Please fill out the form below and send all necessary documents via regular mail to

    Chasin A Dream Foundation, 3900 E Indiantown Rd, Suite 607-195, Jupiter 33477, OR via email to lori@chasinadream.org

    Applications cannot be processed until all information and documents are submitted.

**Please note that financial assistance through our Critical Need Program is not guaranteed and is provided on a case-by-case basis. While we strive to support as many individuals as possible, the availability of assistance depends on various factors and the specific circumstances of each applicant.