STRIPE ASSISTANCE

Charitable Giving for Trisomy 18 Families

The E.WE Foundation is honored to offer STRIPE, a charitable assistance program dedicated exclusively to supporting families impacted by Trisomy 18. We recognize the emotional, financial, and social burdens that can come with this rare disease diagnosis. STRIPE was created to help ease those burdens through a combination of financial support and holistic care resources.

While our program includes direct financial sponsorships, our commitment extends beyond funding. Families may also access educational tools, mental health resources, support groups, and advocacy services—reflecting our mission to walk alongside Trisomy 18 families every step of the way.

In Partnership with Help Hope Live

To broaden access to financial support, we proudly partner with Help Hope Live, a national nonprofit specializing in medical fundraising for rare disease communities. This partnership ensures:

Donations are tax-deductible
Funds are managed securely and transparently
Your government benefits remain protected

🔗 Visit Help Hope Live to learn more.

Requesting Assistance

If you have an infant or child diagnosed with Trisomy 18 and your family needs support, you may apply for assistance by completing the application below.

Waiting Period Policy

Families may submit one application every 12 months. This waiting period allows us to serve more families fairly and to evaluate each request with the most up-to-date information.

STRIPE Assistance Application

Eligibility: This program is only available to infants and children diagnosed with Trisomy 18 and their families.

Section 1: Applicant Information

Go back

Thank you for submitting your application to the STRIPE Assistance Program.

Your application has been received. Be advised that a meeting with our STRIPE Committee is required. A member of our team will follow up with next steps.

How did you hear about us?

Is this request for a child diagnosed with Trisomy 18?(required)

YES → continue NO → stop here. STRIPE is only available to infants and children with Trisomy 18 and their families.

Person completing this form(required)

Parent/Guardian Someone Else

If you are NOT the parent or guardian, please tell us who you are.

Name & Credentials

Phone number

Agency/Hospital/Organization

Section 2: Personal & Contact Information

Parent Email Address (please use an email you check often)

Mother’s First and Last Name

Father’s First and Last Name

Street Address, City, State, ZIP

Telephone Number

Section 3: Demographic Information

We collect this information to ensure equitable access to services and to help address health disparities.

Primary Language Spoken at Home

Interpreter Needed

Marital Status

Mother’s Race

Mother’s Ethnicity

Mother’s Employment Status

Father’s Race

Father’s Ethnicity

Father’s Employment Status

Is this your only source of income? (required)

Yes No – list other sources below

List other sources of income

Combined Annual Household Income (from all sources)

Number of Dependents under 19

Total Household Size (including yourself)(required)

2-3 4-6 7 or more

Insurance Coverage (check all that apply)(required)

Private Insurance (e.g., employer-provided or individual plans) Medicaid (state-sponsored insurance plans) Medicare (for individuals with certain disabilities) CHIP (Children's Health Insurance Program) Tricare/VA (military or veterans' healthcare) No Insurance Other

Section 4: Medical Information

Child’s Name

Diagnosis Type (Full, Mosaic, or Partial Trisomy 18)

Date of Birth (MM/DD/YYYY)

Date of Death (if applicable) (MM/DD/YYYY)

Child’s Gender:

Child’s Race:

Child’s Ethnicity:

Additional Diagnoses (if applicable)

Section 5: Type of Assistance Requested

(Check all that apply) required)

*Financial Assistance (past due living expenses, uncovered medical or travel costs) Legal Assistance (trusts, guardianship, estate planning) Counseling Services (individual/family therapy, mental health support) Advocacy Services (healthcare navigation, insurance help, public benefits support)

*Note: The child with Trisomy 18 must be currently living in the home to qualify.

Acknowledgement

By submitting this application, you confirm that all information provided is accurate to the best of your knowledge. You also acknowledge that assistance is determined based on an internal needs assessment and may require additional verification.

Required Documentation

All applications must include supporting documentation for verification. Examples include proof of diagnosis, income verification, and documentation of requested expenses. Applications without the required documents cannot be processed. Upload Required Documents Here

Families with no income to report should complete our STRIPE Zero Income Statement to support your STRIPE application.

Financial Disbursement Authorization

If your application is approved, you will be required to complete a Financial Disbursement Authorization Form. This authorization permits The E.WE Foundation to securely disburse the approved funds, either through ACH direct deposit or by issuing a check via mail. No funds can be released until this authorization is received.

We Respect Your Privacy

Your privacy is our priority. We will never share your information without your consent. Review our Privacy Policy.

Questions? Contact us at stripe@theewefoundation.org