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HOW IT WORKS

We grant Bucket List Dreams to 18-26 yr olds faced with a life-limiting illness. We grant dreams and experiences ranging from $5,000 - $10,000. Please know an application does not guarantee acceptance. We are currently only serving the state of Colorado.

Once the applicant is accepted, we will contact them to begin dreaming together!

Fill out the application to start the process for your dream fulfillment. We will 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 strive to grant as many wishes as possible and will do our best to fulfill your bucket list wishes! 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)

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