2023 Embrace Washington WISH Application

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The wish program is Embrace Washington's Wish is a program funded by donations to Embrace Washington to grant wishes for children in foster care up to 17 years of age. All information provided to Embrace Washington is confidential .

Date *

YYYY

WISH Request *

Activities/lessons

Bed/mattress

Equipment

Membership

Clothing/shoes

Educational support/tutoring

Other

Required

Please describe the activity/wish and the impact it will have on the child:

(please provide a specific narrative)

Cost:

(if known)

Name, Address, & Phone number to send payments:

(if applicable)

NOTE: Foster parents must pre-register for classes/camps. If your request is for classes/camps, please provide confirmation of registration.

Foster Parent Information: *

Required:

FIRST & LAST NAME

PHONE NUMBER

EMAIL

ADDRESS

Who is making this request? *

Mark only one oval.

Social worker

Foster parent

CASA worker

Other:

Person making this request : *

First, last name and email

From what office is the request coming? *

Mark only one

DCYF

CASA

TRIBAL PARTNERS

Other:

Social Worker Information: *

First & last name, phone number, email

Office Location: *

Child #1 First Name: *

Child #1 Age: *

Child #1 Ethnicity: *

Child #1 Gender: *

Mark only one

Child #2 First Name:

Child #2 Age:

Child #2 Ethnicity:

Child #2 Gender:

Mark only one

Female

Male

Non-Binary

Clear selection

Child #3 First Name:

Child #3 Age:

Child #3 Ethnicity:

Child #3 Gender:

Mark only one

Female

Male

Non-Binary

Clear selection

Child #4 First Name:

Child #4 Age:

Child #4 Ethnicity:

Child #4 Gender:

Mark only one

Female

Male

Non-Binary

Clear selection

Additional Children in foster care:

Please list if you have more in the home

Submit

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