In your community, the opportunity may arise where you meet a special child that could be referred to our organization for a wish. In order to qualify for a wish, the following criteria must be met:

• The child must be between the ages of 2 1/2–18 years
• The child must reside in the state of Michigan
• The child must be diagnosed with a life-threatening and/or terminal illness
• The child’s illness must be verified by a licensed physician
• The child must not have received a wish from any other organization

If you know of a child that meets the criteria listed above, he/she may be eligible for a wish through The Rainbow Connection. Please fill out the referral information below and submit it to our office.

Child's Information


Child's Name

Parent(s) Guardian(s)

Phone
Address

Child's Physician (if known)
Child's Illness (if known)

Your Information


Name

Relationship

Phone
Email