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Wishes and dreams application

We specialize in unforgettable travel experiences for individuals with disabilities.

Are you filling this out for yourself or someone else?

Full Name of Wish Recipient

Wish Recipients Birthday

Wish Recipients Age

Wish Recipients Address

Is the wish recipient aware you are submitting their name for a travel wish?

Has the Wish Recipient received a wish from a wish granting organization within the last 5 years?

If you answered yes

How many travelers in total? (this number includes wish recipient)

Please be advised, this field should include only immediate family members who reside in the Wish Recipient's household

How many of those travelers (Including Wish Recipient) are under 18

Enter each additional travelers First & Last name and age

Primary Diagnoses of Wish Recipient

Please list all requested accommodations

Please list the accommodations, modifications, equipment and/or support you need us to consider when designing the Wish and Dream Trip

List all allergies (if applicable)

What 3 travel destinations would the wish recipient like to go?

Disney World (Florida)

Disney Land (California)

Universal (Florida)

Discovery Cove (Florida)

Sea World (Florida)

Aquatica (Florida)

Gatorland (Florida)

Ocala Zipline (Florida)

Legoland (Florida)

Disney Cruise line

Epilepsy Awareness Day (Disneyland)

Epilepsy Awareness Day (Disney World)

List favorite characters for Wish Recipient and each traveler

Do you understand that if this wish is approved we are booking in 2027-2028?

We fundraise to help each family receive their wish and dream can we count on you to help us with fundraising?

How did you hear about us?

Preferred Contact Method

PhoneEmailEither one works for me

Phone

Email

Please type your name as proof of signature

Thank you!

We have received your application. Someone from Practically Perfect Wishes and Dreams will reach out within 5-7 business days to

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Bad respond

Practically Perfect Wishes & Dreams Corp. is a registered 501(c)(3) nonprofit organization.
All contributions are tax-deductible to the extent allowed by law.

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