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How to Apply for a Wish
Families or social workers interested in submitting an application for a wish from the Marty Lyons Foundation, must first ensure that the child meets our eligibility requirements.
ELIGIBILITY
- The Marty Lyons Foundation (MLF) grants wishes to children, ages 3-17, who have been diagnosed with a terminal or life threatening disease.
- Child must reside or receive medical treatment within the Foundation’s designated geographic locations:
- Alabama
- California
- Connecticut
- Florida
- Georgia
- Maryland
- Massachusetts
- New Jersey
- New York
- North Carolina
- Pennsylvania
- South Carolina
- Texas
- Virginia
- The Marty Lyons Foundation is primarily accepting applications for first wish requests. A wish is considered a first wish request if the child has not received or is not in the process of receiving a wish from any other organization.
- Second wish requests (regardless of the original granting Foundation) are only granted under exceptional medical circumstances and typically considered after 2 years from the time of the child’s first wish. At this time, these 2nd wish requests are subject to a waiting list. To be added to the list for future consideration, please email our Director of Mission Delivery by clicking here.
INSTRUCTIONS
- Four (4) forms are required
- Parent’s – To be completed by the child’s parents
- Physician’s – To be completed by the child’s doctor
- Release & Indemnification – To be completed by the child’s parents and notarized
- Authorization to Release Protected Healthcare Information – To be obtained directly from the child’s medical facility and completed by the child’s parents
- Upon completion, all four (4) forms are to be mailed to MLF’s headquarters
- The Marty Lyons Foundation, 105 Sweeneydale Avenue, Bay Shore, NY, 11706
Downloadable Application Files:
- Application Instructions
- Parent Application Form
- Physician Information Form
- Release and Indemnification Form