Refer a Child Form – Sunshine Foundation

Refer a Child

Referral must be completed by the child’s parent/guardian
Step 1 – Complete the form below
Step 2 – If your child appears to meet the criteria, you will receive a link to the application within a few weeks
Please be aware that Sunshine Foundation has a waiting list that may be several years, depending on location and our funding sources.

Has child, or any child in household, received a dream or wish through Sunshine Foundation or any other wish-granting organization or other organization?*
NOTE: Sunshine Foundation grants the dream of only ONE child per household. We will reach out to various organizations to ensure a dream/wish or other gift has not already been provided.
- Yes
- No
Does your annual household income exceed $75,000? Please select you annual household income.*
A household annual income above $75,000 does not meet the criteria necessary for a child to receive a dream. Financial documents (1040, SSI, SNAP, etc.) will be required when completing the application.
- $0-$75,000
- $75,001 or greater
Child's Information
Child's (Legal) Name*
As shown on birth certificate
First Last
Child's Age (AGES 3-18 ONLY)*
Referral will be declined if child is not between the ages of 3-18
Child's Date of Birth*
MM slash DD slash YYYY
Does your child have a SEVERE/PROFOUND diagnosis (if Autism, Level 3 only)? If so, please list diagnosis.*
MUST be SEVERE/PROFOUND (if AUTISM, ONLY LEVEL 3 will qualify). MUST be DOCUMENTED by your child’s physician during the application process.
Parent / Guardian Information
Please enter the contact information for the individual that will be completing the Application.
Parent / Guardian Name*
First Last
Parent/Guardian Email*
Parent/Guardian Address*
Street Address Address Line 2 City State ZIP Code
COUNTY Family Lives In*
Phone*
Information of Person Completing this Referral
Your Name*
First Last
Your Phone*
Your Email
Relationship to Child*
Tell us why you are Requesting a Dream for this child.
500 characters or less

Refer a Child

Child's Information

Parent / Guardian Information

Information of Person Completing this Referral

Sunshine Foundation National Headquarters

Sunshine Foundation Dream Village