Apply for our programs

Eligibility for our programs: (at the time of application)

Receiving active treatment for childhood cancer at a hospital located in Indiana, Kentucky, and/or Ohio defined as:
- Chemotherapy
- Bone Marrow Transplant
- Radiation
All gifts MUST be age appropriate and related to the arts
Gift requests should provide a therapeutic benefit for your child

A member of Bree's Blessings will contact you within 1 week after receiving your application and provide the required documentation needed to complete your request. We have a verification form that is required to be completed by a medical professional prior to your child being enrolled in our programs. We are happy to assist in any way possible! Most social workers and child life specialists are already familiar with us and the process.

By submitting this form, you agree that all information is true and correct to the best of your knowledge.

Thank you for your interest and we cannot wait to bless your child with a gift!

Verification of active treatment is required at the time of application and we will only request it again if the end of treatment date extends beyond what was provided on the original form.

We would love to serve kids of all treatment statuses and from all states, but unfortunately, we are a newer & growing nonprofit so we must be able to sustain and support the kids in our service region before we can offer any expansions.

Child's First Name

Child's Middle Initial

Child's Last Name

Name child goes by, if different than above:

Child's DOB required

Parent's (or Legal Guardian's) Full Name

The following best describes my child:

Male

Female

Prefer not to answer

Street Address

Street Address Line 2

City

State (XX)

Zip code

Treatment mailing address (if you are traveling for treatment & want your gift shipped to this address). Please list the full address including room or apartment numbers, city, state, zip.

Email Address: Please use a valid email, a lot of information we send comes through email.

Best Number to reach you at:

If we have a question about the gift, what is the best way to reach you?

Phone call

Text Message

Facebook

Child's Date of Diagnosis required

What is your child's diagnosis?

Hospital where your child receives treatments:

Social Workers Name (if you know it)

Link to your Facebook or Caring Bridge Page, if you want to share it. We like to follow our kiddos.

What are you requesting as your wish gift? Please list one item only..

How do you anticipate that this gift will provide therpuetic benefits for your child?

Tell us about your child. What interests/hobbies do they have? This helps us shop for your child.

Are you interested in Blessings Boxes? (a themed box containing age appropriate therapuetic crafts mailed to your child every 2 months).

Yes, this would be beneficial to my child's mental health.

No, thank you. Please save that spot for another child who could benefit from it.

Would you be willing to share a photo of your child with their wish gift(s) once they recieve it? Our board members love to see them! We will not share the photo online or anywhere else unless you sign consent to do so below.

Yes, I'd be thrilled to.

No, please repsect our privacy.

Do you give us permission to share your child's photo outside of our organization? IF so, THANK YOU!! Please check the box below and sign the consent form. This helps us tremendously when applying for grants and when seeking donors/sponsors to support our mission. This will help ensure that we have the means to support as many kids as possible.

If not, we totally understand and will respect your privacy. Please skip the check box and do not sign below.

Yes, you have my permisson to share our child' photo. By checking this box you agree that you are the child's legal guardian and give us permission to share the photo in our newsletter, website and/or social media pages, along with any printed materials to promote and market the products and services we offer. You understand that no compensation will be provided for allowing us to share your photo. Bree's Blessings will not sell or share your child's photo or information.

Please provide your signature for consent to share your child's photos. Do not sign here if you do not want us to share your child's photo.

How did you hear about us?

Are you in need of any additional assistance? We don't typically provide financial support but do network with other organizations who may be able to assist.

Which of the following best describes your child?

Hispanic or Latino

Not Hispanic or Latino

Prefer not to answer

Is anyone in the household a veteran?

Yes

Prefer not to answer

Child's Favorite Tv Show/Character

Child's Favorite Animal

Child's Favorite Color

Child's Expected End of Treatment Date: required

Child's Favorite Holiday

Which option best describes your household income? This helps us when applying for grants and will not effect your eligibility.

Siblings name(s) and age(s) . We sometimes have extra crafts and will send things for the siblings.

I hereby certify that all information is true & correct to the best of my knowledge.

By signing below, you agree that all information is true & correct to the best of your knowledge.

Thanks for submitting!