Application

If you know and love a widow, fill out the application below to nominate them to receive some love from all of us at A Widow’s Wish.

Application

Your Name*
First Last
Your Phone Number*
Your Email*
Your Relation to Widow*
Widow's Name*
First Last
Widow's Hometown*
Widow's Birthday*
Date Format: MM slash DD slash YYYY
Widow's Age
Lifelong Wish You're Hoping to Grant to This Widow*
Biography of Widow*
Tell us about them, their family/living situation, and how they became a widow
Comments
This field is for validation purposes and should be left unchanged.

Please let us know if you any additional questions! We’re here to help you.

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