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ABOUT US
DONATE
- How it works
- Make a donation
FOR PARENTS
- Our Process
- Apply
More

Use tab to navigate through the menu items.

Prior to applying, please make sure to read about how our process works.

Parent Guardian Information

Relationship to child*

First name*

Last name*

Multi-line address

Country/Region*

Address*

City*

Zip / Postal code*

Email*

Phone*

Is this your first time applying for assistance from We Pay Copay*

Yes

No

Are both you and your child legal citizens of the US?*

Yes

No

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