Wish Application Form [Website]

Wish Application Form
Please read carefully before submitting an application.

To be eligible to submit a wish application with We Are Young, seniors must meet

the following criteria:

Age: Must be 70 years or older.

Residency: Must live within the areas served by our organization (Atlantic Canada and Ontario)

Need for Support: Clearly demonstrates why the senior would not be able to
fulfill their wish without We Are Young’s support.

Wish Criteria: Must have an experienced based wish that falls within these three foundational wish activities:
1. Fulfilling Lifelong Dreams: Our team actively engages with seniors, turning unfulfilled aspirations. Empowering them to experience something new for the first time, turning long-held dreams into tangible and meaningful realities.
2. Reliving Passions: Age-related limitations can lead to the sidelining of passions. Our approach involves carefully designing activities where seniors can rediscover and engage in these interests again.
3. Reconnecting with Loved Ones: These moments of reconnection—whether strengthening existing relationships or meeting loved ones for the first time—contribute significantly to the overall emotional health and happiness of the seniors we serve.
Please note that we do not grant wishes for: material items like cars, computers, or watches; services such as legal, medical, or home renovations; financial assistance unrelated to the wish itself, like bill payments; or continuous wishes such as subscriptions or season tickets.

Before we begin, are you submitting this nomination on behalf of yourself or someone else?*

Nominators Name*

First NameLast Name
Nominators Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Nominators Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Nominators Email*
example@example.com
What is your relationship to the senior?*

SpouseChildGrandchildOther Family MemberFriendNeighbourCaregiverHealthcare ProfessionalOther

Applicant (Senior) Information*

First NameLast Name
Applicants Date of Birth*

MonthDayYear
Date
Applicants Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Applicants Primary Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Applicants Email*
example@example.com