Refer a child


Who is eligible for a dream?

The Children's Dream Fund fulfills dreams for children ages 3-18 who have been diagnosed with a life-threatening illness. A child does not have to be terminally ill to qualify for a dream, nor is a dream necessarily the child’s “last wish.” However, the child cannot have had a wish with another organization.

Who can refer a child for a dream?

Anyone can refer a child for a dream– a doctor, nurse, social worker, family member or friend.

How can I refer a child for a dream?

Application forms are available by contacting one of our dream coordinators or by filling in the referral form below. Please provide as much information as possible, particularly the child’s full name and parent/guardian contact information. You may also leave your contact information in case we are unable to reach the family.

Referral Form

The Children's Dream Fund is ready to help every child, age 3-18, referred to us for a dream-come-true. The Children's Dream Fund keeps all information received strictly confidential, and takes pride in making the dream process as stress-free as possible for our families.

PLEASE NOTE: There are several required fields in order to process your referral request, as indicated below by the *asterisk*. If you are unable to complete these fields, please contact our Dream Coordinators at 727-896-6390 or

Referral Form

First Name *
Last Name *
Your Email *
Your Phone Number *
Child's First Name *
Child's Last Name *
Child's Age *
Child's Illness *
Relationship to Child *
Child's Parent's Full Name *
Child's Parent's Full Name *
Child's Parent's Phone # *
Child's Address *
City *
State *
Zip Code *
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