APPLYING FOR A WISH

Screenshot_20220826-222655_Photos (1)_edited.jpg

WISH FORM

The Ebi Foundation Wish Request

We request detailed information, including wishes from other charities, to aid in wish allocation.

Alongside this form, we need an official support letter, dated within 3 months, from an authorized figure (e.g., GP, Consultant). It should confirm the applicant's illness and its severity.

Once received, your application goes to the Trustee's Committee for evaluation based on our criteria. We will contact all applicants within 14 days with our decision to fulfill the wish.

Rest assured, The Ebi Foundation values your privacy and may share data with third parties only with your consent. We may also request photos or interviews to share your story.

Please email supporting letters to enquiries@theebifoundation.com or attach them below.

First name of Applicant

Last name of Applicant

Date of Birth of Applicant

If asnwered other to "relation to applicant" Please specify below:

Phone

If this application is not for you the please input your Full name below.

Is this wish request for the applicant?

Yes

Has the applicant been granted any other form of wish?

Yes

If Yes to "Has the applicant been granted any other form of wish?" Please specify below:

Details of Illness

Details of Wish request and how you feel it will help create lasting memories

Applicants address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Initials

I declare that the info I’ve provided is accurate & complete

In addition to this completed application form, we also require a letter of support. This can be from a GP, Consultant or Senior Nurse Practitioner, Social Worker, Community Nurse, Health Visitor, Physiotherapist or similar support person holding a title of authority. The supporting letter must be on official headed paper and be dated within the last 3 months. We request the supporting letter provide confirmation of the illness/medical condition of the Wish request applicant, along with the severity of this condition/illness.

Upload File

Thanks for submitting! We will be in contact within 7 days.