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Wish number* :
Donation Amount(SGD)* :
Donation Type* :
Full Name / Organisation* :
NRIC/FIN/Business Reg No* :
Mobile No* :
Address Line 1 :
Address Line 2 :
Postal Code :
Payment Method* : Payment MethodVisa/MasterCardChequeBank Transfer
By submitting this form you confirm the above details are correct and agree to Make-A-Wish Singapore’s Personal Data Protection Policy.
Please let us know if you’d like to receive communication materials from us:
I agree that Make-A-Wish Singapore may contact me via direct mailers, newsletters, telephone and electronic communications (including emails and e-newsletters) for updates and/or fundraising purposes.
Child's Full Name* :
Date of Birth* :
Medical Condition :
Referrer's Full Name* :
Referrer's Mobile No* :
Referrer's Email* :
Relation to Child :
Make-A-Wish Singapore is committed to respecting the privacy of the children referred to us for the granting of a wish. Before referring any child to us, please seek the consent of the child being referred, or a parent/guardian of the child (if the child is below 13 years old).
We accept referrals from third parties solely for evaluating prospective wish children for the grant of a wish and where this would be in the interests of such children. We will only proceed with the grant of a wish where consent has been sought from the child (or his/her parent or guardian).
Thank You! Your generous donation will go a long way to inspire hope and deliver strength to our wish children.
Thank you! Your application has been received. We will be in touch with you soon.
Thank you! You message has been sent. We will be in touch with you soon.