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Welcome To The Application Page

If you are interested in our services from the Leona Project all you have to do to get started is to fill out the Application below.  If we are low on funds we inform you of that and your application will be placed on our waiting list in our Data Base. We are on a first come first serve basis. This program helps in so many ways. We not only help raise money for you but if you have already started something of your own we will help you in your own endeavors.  We hope that the application process isn't  difficult.  We tried to make it as smooth as possible, but there are some mandatory questions that needs to be answered in order to weed out the people that really don't have cancer and are trying to take advantage of our system. To get started just fill out the application and hit submit. We look forward to working with you.

    Application For Services

    Personal Information

    Employment Information

    If you are employed please upload your 2 most recent pay stubs or a letter from your employer on letterhead stating your yearly salary. If you have other forms of proof of income not listed please leave a comment below.
    Note: If your answer is yes please upload the appropriate documents.
    Max file size: 20MB
    Note: If you do receive Unemployment  please fill out the next  several fields below. If you don't you may skip and go to the next section.

    Services

    Max file size: 20MB
    We must receive this information before we can proceed with this application. If you cannot up load it you can send it to us at the below address. All information will be kept in a secure place. We Guarantee your personal information will not be shared with any third party. Thank You

    Verification Check (Medical and Employment Verification)

    By Placing your Initials in this space you are letting us know that everything in the application is true to your knowledge and also gives us permission to verify the information on your application. If you choose not to check this space your application will be automatically denied. Please provide your SS# and your date of birth below. We guarantee the safety of your personal information.

    Check List

    PLEASE PROVIDE THE FOLLOWING THINGS ALONG WITH YOUR APPLICATION:


         A COPY OF STATE ISSUED PHOTO ID


        EMPLOYMENT INFORMATION (ACCEPTABLE FORMS BELOW)
              * 2 MOST RECENT PAY STUBS  ( IF APPLICABLE)
                   * W-2 FORM
                   * 2 MOST RECENT UNEMPLOYMENT STUBS (IF APPLICABLE)
                   * NOTARIZED LETTER STATING THAT YOU ARE NOT EMPLOYED ( IF               
                       APPLICABLE)


        COPY OF YOUR MOST RECENT MEDICAL BILL



    Remember if you cannot upload your needed information you can always mail it to us at the Address below,  but please fill out the application before sending us the information. We are trying to make this as seamless as possible but sometimes things can't be and we understand
    PLEASE SEND ALL OF THE REQUESTED INFORMATION TO THE ADDRESS BELOW:


    ALPHA WORLD ENTERTAINMENT INC.
    ATTN: PAULA BROWN
    504 S MARLYN AVE.  SUITE 1A
    ESSEX,  MD. 21221

    WE LOOK FORWARD TO WORKING WITH YOU!!!!!!!!!

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