2027 Rustic Memories Dreams Application & Nomination Form

Rustic Memories Dreams
A program of Rustic Memories All Abilities Foundation, Inc.

Where Every Ability Belongs.
Because some memories can't wait.

Apply for yourself or nominate someone for a 2027 Dream Day or Dream Wedding. Dream Day and Dream Wedding applications are reviewed separately. There is no public vote.

Applications open October 18, 2026. Regular applications close November 30, 2026 at 11:59 PM Central. Urgent medically or time-sensitive circumstances may be reviewed outside the regular cycle.

Private Review • No Fee to Apply • No Public Voting • Optional Video Story

Section 1 — What Are You Applying For?

What are you applying for?

Dream Day

Dream Wedding

Section 2 — Who Is Completing This Form?

Who is completing this form?

I am applying for myself

I am nominating someone else

I am completing the form with/for the recipient as an authorized or requested support person

Section 3 — Applicant / Recipient Basics

Legal name

Preferred name

Date of birth or age

City, State

Phone number

Email address

Preferred communication method

Phone

Text

Section 4 — Tell Us The Story

Tell us about the recipient/couple and what is happening in their life.

How has disability, serious illness, caregiving, treatment, or another mission-aligned circumstance affected daily life or access to experiences?

Why would this Dream matter?

Why does timing matter now?

What similar opportunities are currently available to the person, if any?

Dream Day Questions (Only if Dream Day selected)

Dream Wedding Questions (Only if Dream Wedding selected)

Section 5 — Accommodation Snapshot

Mobility/access needs we should know about for planning

Communication preferences

Major sensory considerations

Power/refrigeration/medical-equipment needs relevant to participation

Caregiver/support-person needs

Service animal needs if any

Transportation/restroom/dietary/temperature considerations if relevant

Anything else that would help us communicate or plan respectfully?

Section 6 — Timing / Urgent Review

Is there a reason this application may need urgent review?

Yes

Section 7 — Your Story, Your Voice

Want to tell us in your own words?
A short video can help the Dream Committee understand the person behind the application. It is optional and choosing not to submit one will not hurt the application. Suggested video length: 1–3 minutes.

Upload a video file

Size limit: 10 MB

OR provide a private video link

Untitled checkboxes field

I'm choosing not to submit a video. I understand this will not hurt the application.

Submitting a video for committee review does not give Rustic Memories permission to post it publicly. Media/story permission is handled separately and is never required to receive a Dream.

Section 8 — Privacy, Verification & Acknowledgments

Applicant & Recipient Privacy Notice — Our Approach:
We collect only information we reasonably need to evaluate, verify, plan, accommodate, or safely deliver a Dream. Application information is not automatically public, is not sold, and is not provided to Rustic Memories for unrelated commercial marketing. Public storytelling is optional and requires separate media/story consent. Applicants may correct inaccurate information, withdraw an application or nomination, and request deletion when no legitimate retention obligation remains. Questions or privacy requests: rusticmemorieswi@gmail.com.
This notice describes the Foundation's program privacy practices. It is not a promise that every healthcare privacy law applicable to a medical provider applies to the Foundation.

Please confirm:

I understand submission does not guarantee selection.

I understand Dream Day and Dream Wedding are limited charitable programs and not cash prizes.

I understand finalists may be asked for limited professional verification.

If this application reaches finalist review, I authorize the Foundation to ask me for limited professional verification.

I understand I should not upload full medical records unless specifically requested.

I understand media/story participation is separate and is not required to receive a Dream.

I have reviewed the applicant privacy notice.

The information provided is accurate to the best of my knowledge.

I understand selection is private and is not based on social-media votes, fundraising totals, publicity value, guest count, bar revenue, or a relationship with Foundation leadership.

Signature and Date

Sign here