Initial Dream Request Form

Initial Dream Request Form

Please fill out the following information to help us get started with your Dream request. Upon receipt of the initial request, we will contact you.
Dream Qualifiers & Priorities

The adult recipient has been diagnosed with a life threatening or terminal illness and lives in Blount, Knox, or Sevier County in East Tennessee. Ability to participate in the DREAM physically and/or emotionally. Priorities given to: Hospice Patients, Veterans, Active Duty Military, Qualified Financial Hardships, and Most Immediate Need. Dreams are an experience with no real asset value.
Recipient Information:
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Phone Number*
Format: (000) 000-0000.
E-mail
example@example.com
Does the recipient meet the qualifications of our mission?Does the recipient live in Blount, Knox, or Sevier County in Tennessee?Is the recipient a Veteran (or active service)?Can the recipient participate physically and/or emotionally in the dream?Does the recipient have a potential financial hardship?
Requestor Information:
If different than Recipient, please fill out the following form.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Email
example@example.com
Phone Number
Format: (000) 000-0000.
How did you hear about us?
Please Specify
Please provide the YOLO Foundation with any information about a Dream you have that you wish to have granted. It is helpful if you can provide as much information as possible and if you have more than one Dream you'd like to have granted, but not required.
Should be Empty:

Initial Dream Request Form

Dream Qualifiers & Priorities