You have been nominated for a Gift of FUN! from the Karen Wellington Foundation for LIVING with Breast Cancer. When a calendar is filled with a seemingly endless stream of doctor appointments, tests, procedures, treatment and follow-up visits, leaving little time for much else. KWF thinks it is important to add something different, something FUN to your calendar to provide you a break from those dreary medical appointment and something to look forward to NOW. The intent of our gift is to provide an escape designed to help balance mind, body and spirit by putting something on the calendar NOW. With a goal to reach as many women and families as possible, we typically limit gifts to first time nominees. For greatest impact, we try to connect with recipients during treatment or within six months of their last treatment.

KWF is committed to positively serving ALL women living with breast cancer.  Diversity, equity, and inclusion are core to our strategy.  For this reason, it is helpful to analyze in aggregate the impact of our work.  Proving the information below is completely voluntary, and will not impact the decision-making process of giving gifts of FUN in any way.

Your Medical Information

Please submit a screenshot of your diagnostic report from your "MyChart" or online medical portal.
In the screenshot, we will need to see the following items:

• Your first and last name
• The Name of your treatment center
• Your diagnosis
• The date of your diagnosis
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A how-to for Windows users can be found here.
A how-to for Mac users can be found here.

Medical Team/Primary Hospital (required):

Current treatment plan or next steps:

Please share a bit about your journey (required):

Please tell us about your family or support system (required):

How many people are in your immediate family? (required):

Rate your emotional / mental well-being today:

Help us get to know you and design your gift of fun

Please list your hobbies (required):

When it comes to fun we want you to think outside the box. Share some of your bucket list ideas and biggest wishes. Keep in mind we have done Gifts of Fun ranging from dinner dates, to skydiving, VIP experiences at the zoo to meet and greets with sports teams, tickets to the theatre, to private art classes. These gifts are all thanks to our donors and partners.

What type of FUN are you interested in?  (To select multiple options, press 'Ctrl' while making your selection.) Required.

Have you traveled in the last 6 months or do you have any upcoming travel plans? (required)

Please list your favorite food or restaurants:

Is there anything else you want us to know about you?

Share your social media handle(s) with us

Please upload 2 photos of yourself. (required)