Return to mobile version

Referral Inquiry

Every wish experience begins with a referral.

Together, we create life-changing wishes for children with critical illnesses. Our vision is to grant the wish of every eligible child in New Jersey.

Fill out the brief inquiry form below. Your information will be forwarded and you will be contacted by a member of our wish-granting team to determine if your child is eligible.

Wishes can't wait. Refer your child today.

Referrer Information
*
*
*
*
Wish Child Information
*
*
*
*
*
Contact Information
*
*
Make-A-Wish® New Jersey
Samuel & Josephine Plumeri Wishing Place
1384 Perrineville Road
Monroe Township, NJ 08831
(609) 371-9474
Toll Free (800) 252-9474