Make a Wish

As much as we would love to help everyone we can, we must remain focused on our visions in order to maintain efficiency. Our mission is to help the dreams come true of sick and disabled children.

Nomination Criteria

In order to qualify, the recipient must meet the following criteria:

• Child must be under the age of 21
• Diagnosed with a life-threatening illness
• Have an official Statement of Diagnosis sign by primary physician

What We Need

If the child meets the above requirements, here's how to nominate a child:

1. Complete Nomination Application (Spanish Version)
2. Complete Medical Records Release Form
3. Complete the Consent Form
4. Email the Nomination Application, Medical Records Release Form, Consent Form and Statement of Diagnosis with 2-3 images of the child to info@payitforwardnetworking.com