Illuminate 2025: O’ahu

Application

We are so honored by the interest in our Illuminate Retreat and are grateful you’re taking the time to apply! Each year, we receive many applications from incredible young women, and while we wish we could accept everyone, we are only able to bring 10 attendees on each retreat.

Every application is carefully and thoughtfully reviewed. The more thorough and personal your responses are, the better we’re able to get to know you, so take your time and share your story with us!

Applicants will be notified of their status via email by July, so please be sure to check your inbox regularly, and don’t forget to look in your junk or spam folders just in case.

We can’t wait to learn more about you!

Name

First Name

Last Name

Phone

(###)

###

####

Date Of Birth

YYYY

Age

Location

State of residence

Instagram Handle

Diagnosis

Hospital Info

Hospital where receiving treatment

Social Worker Contact

If not already referred by a social worker, please provide social worker contact info. We will be confirming diagnosis and background. If you do not have a social worker, please provide doctor information.

Treatment Status

Currently on treatment

Recently completed treatment or transplant (within 5 years)

Your Story

Tell us about yourself! Share about your cancer story so far, your interests, etc.

Who or what inspires you?

Why do you want to attend the Illuminate Retreat?

How did you hear about Illuminate?

Mental Health Info

Please let us know of any mental health history (anxiety, depression, PTSD, etc.) or vital information you think we should know

Other Medical Info

Please let us know of any other medical information you think we should be aware of

Scholarship Information

If applying for airfare funding from Lighthouse For Hope, please let us know your annual household income.

Funding Needs

We believe everyone should be able to attend this life-changing experience, regardless of financial restraints. Please let us know of your current financial needs so we can better assess your situation, including if you are seeking full or partial funding for your flights.

Occupation

I Understand

That Lighthouse For Hope works hard to raise funds in order to create a meaningful and magical experience through the Illuminate Retreat. If, for any reason, I am no longer able to attend, I will notify Lighthouse For Hope as soon as possible so that they can plan accordingly and fill my spot. I also understand that in the event of a last-minute cancellation, Lighthouse For Hope is not responsible for any lost or non-refundable airfare costs.

I understand

Additional Information

Please use this space to share anything else you’d like us to know! This could include special circumstances, personal insights, questions, or anything that didn’t fit elsewhere in the application but feels important to your story or experience. While this section is optional, we welcome anything you’d like to add to help us better understand you.

Illuminate 2025: O’ahu

Application

© Lighthouse For Hope 2025

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