Recipient Application

Do you know a child that is deserving of a doll? We want to hear about them! Please complete the application and we will be in touch within one week.

 

Please complete the form below

Checkbox *
Your Name *
Your Name
Phone
Phone
Nominee's Name *
Nominee's Name
(Hair Color, Eye Color, Skin Tone)
Reference Contact *
Reference Contact
Please include one additional reference, preferably a teacher, pastor, friend, nurse, counselor or school administrator.
Contact's Phone
Contact's Phone
If nominating through Child Advocates, please include the name of your AC
If nominating through Child Advocates, please include the name of your AC