Request A Wish

If you would prefer to mail or fax in your request, please click here to access a printable copy. You will need the free adobe acrobat reader software to view this file.

The Granted Wish Foundation accepts one wish per person/family. If your original wish was not granted, you may not submit a new request for a different wish.

Read the important Wish Request Information Below, complete the form and click the submit button.

Important Wish Request Information and Disclaimer:

Please read our FAQ's And How Wishes Are Granted section before completing and submitting this form.

To request a wish from outside the continental United States, please click here.

All fields marked with an * are required

Requester's Information
 
First Name: *
Last Name: *
Address1: *
Address2:
City: *
State: * Zip: *
Phone: - - *
Email: *
Nominee's Information
 
First Name: *
Last Name: *
Address1: *
Address2:
City: *
State: * Zip: *
Phone: - - *
Email: *

 
Wish Information:
Please state the exact wish you are requesting.
*
 
Detailed Information:
Please provide information about the wish request, the nominee and why you feel this person deserves this wish to be granted. Include any family background, medical or financial hardships, etc.
*
 
How did you hear about The Granted Wish Foundation?


If you chose "Other" Describe Here:

 

 
The Granted Wish Foundation is a non-profit organization registered with the State of Ohio and has been granted IRC 501(c)(3) tax-exempt status by the IRS.