Tina's Place Application Process

Tina’s Place Applications for 2018 are CLOSED. Anyone applying will be put on a waiting list. If cancelations occur, waitlisted applications will be notified in no certain order.


  • Read Tina’s Place FAQ page on our website to understand all the requirements prior to filling out an application.
  • ALL applicants must "like" our Facebook page or follow us on Twitter.

    Facebook: https://www.facebook.com/tinasplacemi
    Twitter: https://twitter.com/tinasplacemi
  • Fill out the application on our website in its entirety.
    If you fail to do so, your application will not be processed.
Requirements for Tina's Place attendance:
Patient (adult or child) must have a current diagnosis and be under treatment for Stage III or Stage IV melanoma. If an application is approved, the patient will be required to supply medical verification and clearance from their oncology healthcare team. Previous guests or cancellations may not reapply.

Applications are NOT first to come, first served. Once your application is received, the board will review it closely and inform you only if your family is selected to attend. Due to the large volume of applications, we cannot respond to every application.

Note: The application which follows asks if this would be your family's only get away for the year. Please apply, whether your answer is yes or no. While we do not restrict our guests to only those who have no other vacation options we're especially eager to assist those families who have no other opportunity to escape the daily grind of melanoma treatment.

*Tina's Place reserves the right to fill dates and offer/rescind an invitation with or without explanation, cause, or reason.

* Indicates a Required Field

Guest Information
* Required Questions:
  I have read the FAQ page
  I have liked/followed Tina's Pace on Facebook or Twitter

Would this be your family’s only chance of a getaway/vacation?
   Yes    No
* First Name:
* Middle Name:
* Last Name:
* Email:
* Home Phone:
(Numbers only please, no spaces or special characters)
* Cell Phone:
(Numbers only please, no spaces or special characters)
* Address:
Address 2:
* City:
* State/Province:
* Postal Code/Zip Code:
* Age:
* Sex:
* Your Facebook Personal Profile URL:
(ex: https://www.facebook.com/tinasplacemi)
Dates and Guest Information
Please check 3 dates that work for you:
June 06 - June 17
June 18 - June 24
June 25 - July 02
July 08 - July 16
July 23 - July 29
July 30 - August 05
August 06 -  August 12
August 13 - August 19
August 20 - August 28
September 1 - September 09
September 10 - Setptember 16
September 17 - September 23
September 24 - September 30
October 01 - October 07
October 08 - October 15
All of these dates work for me!
Number of immediate family members (up to four) you're hoping to bring with you, including spouse/partner/kids 18 and under:
Names, Ages and Relationship of those attending:
Cancer Diagnosis Information
* Initial Diagnosis:
* Stage:
* Oncologist Name:
* Oncologist Phone:
Medical Treatment and Limitations
Explain what treatment you are currently on:
Can you climb stairs to get down to the cabin:
Do you have any physical limitation:
Please explain why you should be selected to be our guest. Include any information you deem appropriate, such as financial hardship, and whether this would be your family's only chance for a getaway. Provide any other information that may help with our Application Committee review process:

(maximum 1000 characters)
How did you hear about Tina's Place?
Form Validation

Please enter text in image:

Once we receive your application, we will review it closely. Due to the large number of applications we receive, you will only be contacted if you are selected.

If you have any questions, please contact us at tinasplacemi@yahoo.com. We look forward to reviewing your application!

Tina’s Place Applications for 2018 are CLOSED. Anyone applying will be put on a waiting list. If cancelations occur, waitlisted applications will be notified in no certain order.

"Take care of your body. It's the only place you have to live."

- Jim Rohn

Donate Now and join us in our efforts by making a donation today.

Tina's Place is dedicated to providing melanoma patients a free haven. Donate now to help support the cause.