Apply for a Wish

 

Wish Recipient Requirements

All of the following requirements must be met before a wish will be considered:

  1. Must be a resident of Western New York
  2. Must be 65 years of age or older
  3. U.S. Citizen
  4. Annual income must be less than $38,000 for a household of one or $44,000 for a household of two OR a permanent resident of a care facility
  5. Must be cognitively, emotionally and physically capable of communicating and experiencing the wish. (You do NOT need a medical diagnosis to apply for a wish)
  6. Unable to fulfill the wish on your own or with family assistance

Proof of age, physical condition per a physician’s letter and/or citizenship must be provided if requested at a later date. You may also attach this information to the application. 

Granting Wishes

Wish applications are reviewed upon receipt to determine eligibility. A “Wishes Committee” meets every other month to review completed wish applications. If a wish is approved, the recipient is notified and the process of granting the wish begins. Senior Wishes grants qualifying wishes as funding and resources become available. We regret that not every qualified wish can be granted and Senior Wishes has sole discretion in the decision to grant or deny a specific wish from an applicant. All applicants will receive a response, usually within 1 week of the wish granting meeting.

Types of Wishes Granted 

We strive to grant wishes that will make a significant impact on a senior’s quality of life and bring them great joy. Wishes might be to reconnect with a loved one, visit a hometown, visit a favorite place, participate in an activity a person used to do, celebrate a passion, etc. Wishes may also fulfill a lifelong dream such as ride in a hot air balloon, go to a ballgame, learn a new skill, etc. Wishes must have significant meaning to the senior.

Restrictions On Wishes

The following requests will not be considered:

  1. Vacations or travel outside of the continental United States
  2. Household Furniture
  3. Housing reconstruction, repair and maintenance
  4. Bill payments or requests for cash
  5. Medical items – including surgery, prescriptions, hearing aids, dentures
  6. Physical assets such as houses, vehicles, etc.
  7. Legal or Employment Services
  8. Local transportation requests

Printable Application

 

Senior Wishes Application

Contact Information of Wish Seeker

Must submit proof of income upon request

MM/DD/YYYY

Proof of age must be submitted upon request

Please fill out this section only if you are nominating someone for a wish

Wish Details (Please list ONE wish only)

Declaration

I, the undersigned, acknowledge acceptance of this application does not guarantee fulfillment of my wish. I declare that my annual income is not over $38,000 for a household of one or $44,000 for a household of two or that I am a permanent resident of a Care Facility. I understand that I may be asked to show proof of income. (May be submitted with application to avoid delays) I declare that all information provided by me is accurate and I agree to inform Senior Wishes should any information on this application change. I understand that I may be asked to provide a medical verification form and that I will need to sign a liability release prior to my wish being granted.

 

Please direct any questions to Wendy Backman, Executive Director at 508-2121.

UCHS Inc. is the proud founder of Senior Wishes