Refer a child
Criteria Screening Form

Criteria Screening Form

What is child's date of birth?

Date

Sunshine Foundation serves children between ages 3 & 18.

Are you the child’s parent/legal guardian?

Yes

Your child MUST be diagnosed with a SEVERE/PROFOUND physical/developmental/intellectual challenge or trauma from
physical/sexual abuse to qualify.

All diagnoses must be confirmed by your child’s physician on the provided Medical Authorization Form
Please select from the list of qualifying diagnoses. If your child’s diagnosis is not listed, check with your child's physician.

Primary Diagnosis

Note: If diagnosis is critical or life-threatening, please reach out to your local Make a Wish organization.

Secondary Diagnosis

Please select your annual household income. This amount includes your adjusted gross income (line 11 from current 1040 Income Tax Return statement) AND any other sources of income, both taxable and non-taxable, e.g., SSI, SSDI, child support, SNAP benefits, etc. Total household income must be under $75,000 annually to qualify.

Financial documents (1040, SSI, SNAP, etc) are required and will be verified during the application process.

Up to $75,000

$75,001 or greater

Has the child or any other children in the household been approved or received a dream from Sunshine Foundation or any
other wish-granting organization?

Sunshine Foundation grants the dream of only one child per household.
We will reach out to wish-granting organizations to ensure your child has not been approved or received a previous dream.

Yes

I understand that I may apply for only one wish/dream per household.

Yes

Is the child a citizen of the United States and residing in one of the 50 states or District of Columbia?

We check through documentation

Yes

Submit your email address and cell phone number to create an account:

Please click 'Verify' and enter the code sent to your email/phone to complete the verification.

Enter Email: Verify

Cell Phone: Verify

Continue

Refer a child Criteria Screening Form

Criteria Screening Form

Refer a child
Criteria Screening Form