Anyone Can Refer A Child

Whether you’re a family member, friend, nurse, doctor, or social worker—thank you for your interest in nominating a deserving child for a wish. Kids Wish Network is committed to infusing hope, creating happy memories, and improving the quality of life for children experiencing life-altering situations.


Does Your Child Qualify?

First, let’s see if the child you’re nominating meets the requirements to receive a wish: 

Qualifications For A Lifetime Wish

Qualifications To Become Hero of The Month

When filling out this form, you will notice there are required sections indicated by an *asterisk*. Please give as much detailed information as possible. It is important to provide the child’s full name and accurate parent/guardian contact information. You may also leave your contact information in case we are unable to reach the family. Thank you for your gift of caring.

If there is required information that you are unable to provide, please feel free to call us toll-free at 727-789-0008 with your referral.

Your Name(Required)
Parent or Gaurdian Name
Enter "same same" if same as name above.
Child's Name(Required)
Enter "same same" if same as name above.
Address(Required)
Has the child had a wish granted before by ANY wish granting organization?(Required)
Please enter a number from 0 to 100.

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