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HOW IT WORKS

We are dedicated to fulfilling the dreams of young adults, ages 18-26, who are facing life-limiting illnesses. Please note that submitting an application does not guarantee approval, as each request is carefully reviewed.

Currently, our services are available exclusively to residents of Colorado.

During the selection process, we may reach out for additional information. If your application is approved, our team will contact you to begin turning your dream into reality!

Fill out the application to start the process for your dream fulfillment. We may contact you for more information!

DREAM APPLICANT NAME

First Name

Last Name

Phone

What is the best way to contact you?

Phone

Address

Age

Birthday

Diagnosis / Illness

MEDICAL REFERRAL SOURCE

Name of Hospital or Medical Facility:

Medical Contact First Name

Medical Contact Last Name

Medical Contact Phone

Medical Contact Email

SECONDARY CONTACT NAME

Please list a family or friend we can contact in regards to your dream, we will always try to contact the dream recipient first

Secondary Contact Name

Secondary Relationship

Secondary Phone

Secondary Email

How Did You Hear About Project Sol Flower?

TELL US ABOUT YOURSELF

Have you made a bucket list? (It's okay if you aren't sure, we will help you dream)

What's on Your Bucket List? The more the better

How has your illness / diagnosis impacted you?

Does your dream have any time restrictions? (is there a certain date you want your dream granted on?) We aim to fulfill dreams within 6 months of being accepted

Thank you for your application!

We will be in touch!

Additional Interests - Select All That Apply

Denver Broncos

Colorado Avalanche

Denver Nuggets

Concerts - Please include details in your bucket list answer

Other - Please include details in your bucket list answer

None of the above

(This helps us when we receive last minute donated tickets)

Applicant Signature

I, the Project Sol Flower Applicant, grant Project Sol Flower permission to obtain any necessary medical information to evaluate and fulfill my bucket list dream request.

Additionally, I authorize all healthcare providers involved in my care to release such information to Project Sol Flower upon request. I agree to sign any additional medical authorization forms required to facilitate this process.

If you are submitting this application on behalf of a dreamer, please provide a signed medical release form below:

Project Sol Flower Medical Release of Information Form

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