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.

The Applicant

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

The Dream

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

Contact Details

Please tell us how we can contact you.

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.

Thank you

We have received your form. Many thanks.