Apply For Gift 


Julia's Butterfly Foundation provides assistance to terminally and chronically ill children, with a concentration in the tri-state area (NY/NJ/CT). We pay directly to the provider and never to the patient, to avoid any tax liability for the family. Julia's Butterfly Foundation does not discriminate based on race, color, gender, religion or illness and reserves the right to distribute funds at its sole discretion.


The guidelines and application can be found below. All applications may be submitted via mail or email. No faxes will be accepted. Please do not provide any social security information. Please download the application below and complete all pages. Then scan your pages and submit to email or snail mail.


Please note that the board reviews all applications and does their best to provide an answer as quickly as possible. An application must be submitted in full and an incomplete application will delay the process. Please note that the board reviews all applications and does their best to provide an answer as quickly as possible. An application must be submitted in full and an incomplete application will delay the process. Please download the application below and complete all pages.

Email your completed application to:


You may also mail your application to:

Julia's Butterfly Foundation

5 Sicomac Road

Number 13
North Haledon, NJ 70508


5 Sicomac Road Suite 13 * North Haledon * New Jersey 07481 * 973-304-4732 *

1.    All applications should be filled out using the application dated 11/1/19 at the bottom of the page. Questions may be submitted using the email address.

2.    All applications need to be scanned into one PDF file and emailed to You may also mail the application to the foundation’s office, address above - however, no faxes will be accepted.

3.    Incomplete applications will not be considered and additional information may be requested.

4.    Every request must include a filled in application and copies of all current invoices in order to be considered complete.  Do not write “See Attached” in any section or your application will be returned. Further, all doctor/social worker documentation must be written and dated within one year. 

5.    Children’s photographs and a media release are recommended and become property of Julia’s Butterfly Foundation, Inc. and will not be returned.

6.    Subsequent applications for the same child within the same year may be resubmitted using a copy of the original application, noting any updated information and requests in Section 9. Invoices and other supporting documentation must accompany the application. The application must be signed and dated at the time of subsequent request in the section provided. 

7.    All invoices must be legible and clearly show appropriate account numbers and mailing addresses at the time of submission. Illegible invoices will be returned and will delay the processing time.

8.    Request for for rent assistance must include a lease agreement with the name and address of the landlord. In cases where there are 2 names on the lease, please provide an explanation and relationship to the child. 

9.    Evidence of family’s financial situation includes tax return, W2 or pay stubs. Please remove all social security numbers from these documents before submitting or the application will be returned. 

10.    We understand that bills are often past due when they are submitted. The Foundation reviews applications on an ongoing basis and provides its best efforts to review time sensitive applications as quickly as possible. It may take several weeks after an application is reviewed and approved for payment to reach the vendor and be applied.

11.    All Government Assistance certificates for Section 8, SSI, Disability, Food Stamps, utility assistance, etc. must be included with the application at the time of the request.

12.    Once the request has been denied, that request will not be reconsidered.

13.    We reserve the right to limit the total amount of giving to an individual family.

14.    Family member and social worker email addresses are required. A copy of paid invoices will be emailed. 


    Julia’s Butterfly Foundation, Inc. (JBF) is a registered 501 (c) 3 charitable organization. JBF is comprised of an all volunteer staff and we make every effort to review all applications in a timely manner. We reserve the right to distribute funds at our sole discretion and do not discriminate based race, color, gender, religion or illness. By signing below, I/we acknowledge that we have read the guidelines of JBF and agree to the terms. Please note:  the foundation does not pay doctor, hospital, or for prescription drugs of any kind and does not make any payments directly to any families, nor do we pay credit card bills. We cannot provide gift cards, with the possible exception of grocery cards, determined on an individual basis.