Riteway Linen & the Doctors Goodwill Foundation

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Medical Fund Assistance Program

Riteway Linen Services has created a program with The Doctors Goodwill Foundation to create a Medical Fund Assistance Program that will be dedicated to helping our Friends and Family in the Hospitality Industry that have been stricken with Cancer.

The Mission of The Doctors Goodwill Foundation Medical Fund Assistance Program is to provide funding to assist with medical bills and living expenses through the sale of the “Wrap Out Cancer” SolReya Breast Cancer Riteway linens purpose in co-creating this program with the Doctors Goodwill Foundation is to help eliminate the additional stress incurred by medical bills so patients and survivors can focus on their future.

How our Program Works:

For a period of one year Riteway Linen Services will promote the sale of the SolReya Wrap Out Breast Cancer Head Wraps and donate $1.00 of each sale with those proceeds going to the program applicant winner.

Criteria and eligibility:

Applicant must be a survivor or have been diagnosed with Breast Cancer and in current treatment. The program was set up to provide assistance to our friends that work so hard caring for guests in the hospitality industry so the applicant must either be in the hospitality industry or have a direct relative in the Hospitality Industries.

General Instructions:

1. DEADLINE for scholarship applications is ___________________. (no exceptions).

2. Refer to application process below for a list of the supporting documents needed (i.e., reference forms, evidence

of illness, etc.) Incomplete applications will not be considered.

3. If any question does not apply to you in this application please put N/A in the space.

4. Type or print legibly. Illegible applications will not be considered. You may also download a copy of the

application online at www.ritewaylinens.com/wrapoutcancer.com

5. You will be notified by mail in ___________regarding the status of your application.

6. If you have any questions about the application, please email info@ritewaylinens.com

Deadline for the application is ___________________. Applications postmarked after this date will not be considered.

Please mail OR submit application in person to:

The Riteway Linen & the Doctors Goodwill Foundation Medical Fund Assistance Program

Attn: Lisa Mowers

679 NW Enterprise Drive Ste. 104

Port St. Lucie, FL 34986

The Riteway Linen & the Doctors Goodwill Foundation

Medical Fund Assistance Program Application

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Name*
First Last
Email
Date*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Date of Birth*
MM slash DD slash YYYY
Are you related to any of Riteway Linen & the Doctors Goodwill Foundation Medical Fund Program Members (Please circle)*
- Yes
- No
Your involvement or Relationship with the Hospitality Industry:*
Please Provide a list of current medical Expenses below:*
Books:
Room & Board:
Other expenses:

I hereby affirm that all the above stated information provided by me is true and correct to the best of my knowledge. I also consent that my picture may be taken and used for any purpose deemed necessary to promote the Foundation’s Medical Fund Assistance Program.

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