Care Package Request

Has your child or teen recently been diagnosed with cancer, or a chronic or terminal illness? If we believe it would be beneficial, the Silly Lily Foundation is here to provide a care package to offer support. Our care packages are thoughtfully designed to bring comfort and joy during these tough times. Each package includes items tailored to the recipient's age and interests, such as cozy blankets, captivating books, art supplies, and small toys. We also include encouraging messages and resources to assist both the child and their family. Our mission is to provide a bit of light and love, reminding you that you are not alone on this journey.

Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What is your child or teens diagnosis/story?

When was he/she diagnosed?

Does your child or teen have any restrictions, allergies, or medical devices?

Gender

Boy

Girl

Prefer not to say

How old is your child/teen?

What hobbies does your child/teen cherish the most? Do they have a favorite color, animal, craft, or something specific they've been longing for? The more details you provide, the better we can ensure they receive a gift they'll truly adore!

Anything else you would like us to know?

If we receive your approval, may we share the care package and any photos you provide on our social media? If so, could you please provide your social media handles?

I acknowledge that submitting this form does not guarantee a care package; it merely serves as an application. The Silly Lily Foundation will reach out if it deems a suitable match!

I understand!

I don't understand