Holiday-Birthday Special Assistance Program

 

 

 

 

 

 

 

PURPOSE:

PWSA of WI, Inc. believes everyone with PWS should feel special and continue to have
special memories and gifts – no matter what their age. As many adults with PWS are
aging, they are often outliving parents and family members. These individuals have no
one to provide them with a gift or card on special occasions such as Birthdays or
Holidays. PWSA of WI, Inc. has developed the Holiday – Birthday Special Assistance
Program to help meet this unique need of these individuals.

ELIGIBILITY:

  1. Any adult with PWS 18 years or older who no longer has family members of friends who can provide them with a present, card or some sort of gift for the holiday or birthday celebration.
  2. The adult with PWS must reside in the State of Wisconsin.

An adult with PWS can participate 2 times in one year for this program – one
holiday and one birthday request per year.

Name of person with completing application

Address

City

State

Zipcode

Email address

Cell phone

Name of person with PWS

Address of person with PWS*

Relationship to person with PWS*

Occasion for request*
 Holiday Birthday

The above named adult with PWS no longer has family members who can provide for his/her holiday and/or birthday celebration needs and would benefit from the gift card being provided by PWSA of WI, Inc. I certify that all of the information given above is true and correct. I understand that any false or incomplete statements in this application may
make this application ineligible for funding.

I accept*

*Required field