Get ready to apply
American Childhood Cancer Organization
Take a Pop, Share a Smile
What you get
Help with freezer and replenishment for participating centers and freezer pops for patients. Your social worker can ask whether requests are open.
- Who starts it
- You
- How it’s sent
- Email to tschilling@jelsert.com
- Your time
- An hour or so
- Last checked
- Aug 27, 2026
Before you start, check you fit
- No direct household shipment is offered.
- Participation, patient selection, inventory, and allergy or dietary accommodations vary by treatment center.
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What their form asksA preview, so you can gather things first. Fill it in on their site.
Open their application ↗ Checked Aug 27, 2026Send it by email to tschilling@jelsert.com.
What the form asks for
Form Submitter InformationI am completing this form becauseYour First NameYour Last NameYour EmailYour Phone NumberTake a Pop, Share a Smile Program InquiryPreferred Method of Contact (Select One)Your EmailYour Phone NumberHospital Affiliation (if any)Additional InformationNominate a HospitalHospital NameCityStateWebsiteHospital Contact NameTitle/PositionHospital Contact EmailHospital Contact Phone NumberWhy are you nominating this hospitalEnroll my Hospital in the Program · your care team fills this inHospital NameWebsiteShipping Address Line 1 and Line 2CountryProvinces / State/Province / StateCityPostal CodeContact #1 First Name, Last Name, Title/Position/Department, Email, and Phone NumberContact #2 First Name, Last Name, Title/Position/Department, Email, and Phone NumberWe would like to orderDepartment where freezer/pops will be locatedNumber of patients per week (in freezer/pops location)How will your hospital/facility benefit from this programFreezer Pop Replenishment · your care team fills this inName of organizationShipping addressReceiving contact's nameBest contact phone number
After you send
The coordinator follows up with the submitter, nominated hospital contact, or enrolling hospital contact according to the chosen route. If you have not heard back in two weeks, write and ask whether it arrived.
