Request a Dream form

Would you like to request a dream, either for yourself or someone else? Please complete the form. We aim to respond to dream requests within 10 working days.

Please note that all information you provide will be kept confidential. Unfortunately, we cannot guarantee to grant all dreams. We grant dreams to children and young adults with life-limiting or life-threatening conditions and/or severe disabilities. We grant dreams to those living in and around Greater London (70 miles radius approx).

Who is the dream for?

Tell us about yourself. Or if you are applying for someone else, tell us about him/her.

Full Name

Date of Birth

Home Address

Postcode

If under 18, name of parent or guardian

Tell us a little about your illness or disability

The Applicant

If you are applying on by behalf of someone else, please fill in this section.

Your Name

What is your relationship to the person who wants to be granted a dream? (eg parent, guardian, carer, teacher etc)

The Dream

Tell us a little about the dream you are requesting. You can give up to 3 different dreams in order of preference.

Dream request 1

Dream request 2

Dream request 3

Have you ever been granted a dream by another charity or organisation

Yes No

If your answer to the above question is yes, please tell us about the dream(s), who granted them and when were they granted.

Contact Details

Please tell us how we can contact you.

Your email

Your phone no

General Data Protection Regulations

We promise never to pass on your details to another organisation for marketing or any other purposes. We will store your data confidentially and securely. Our privacy policy (viewable here) covers in more detail how we store and protect data. Everything you tell us will be treated confidentially.

General Data Protection Regulations

I agree to The Dream Factory data protection policy, as described above.

Request a Dream form

Who is the dream for?

The Applicant

The Dream

Contact Details

General Data Protection Regulations

Thank you