Request a Bag

Contact: info@myhopebag.org

The person receiving the bag MUST BE AN ARIZONA RESIDENT. When you click on “Request a Bag”, you will receive an email requesting you to “subscribe”. Please click on that so the request will get to My Hope Bag. That is all you are subscribing to.

Name & Address of Bag Recipient (if different than above)

I am requesting a bag for*:

Breast Cancer*...

The specific type of breast cancer I have/had*...

Since being diagnosed, I struggle most with*...

Age when I was diagnosed*

My age now*

How I heard about My Hope Bag:*.

Please list specific referral in the "other" field.

Any additional information I'd like to provide or any questions I'd like to ask:

The person receiving the bag must be an Arizona resident. When you click on "Request a Bag", you will receive an email requesting you to "subscribe". Please click on that so the request will get to My Hope Bag. That is all you are subscribing to.