Refer a Child Form – Sunshine Foundation

Refer a Child

Thank you for your interest in referring a child. A child may be referred by anyone, with the permission of the child’s parent(s) or legal guardian(s). However, if you are not the child’s parent(s) or legal guardian(s) you must provide an email address for the child’s parent/guardian. Please be aware that Sunshine Foundation does have a waiting list that may possibly be several years depending on location and our funding sources. Therefore, if your child appears to meet the criteria, please be sure to submit and complete the referral as soon as possible.

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. In order to ensure donor funds are being utilized appropriately, we will reach out to various organizations to ensure a dream/wish or other gift has not already been provided.
- Yes
- No
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
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