Magical Memories for Special Kids
Winnipeg
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Agency or Organization Application

Agency or Organization Information:

Name of Agency or Organization Rep

Note: You must provide contact information that is valid between now and the flight date. If your agency closes for the summer - our DTF Directors still need to contact you! Do NOT provide contact information that may not be valid during certain times of the year - specifically for school applications.

Address of Agency or Organization

Additional Information:

Agency / Organization Acknowledgements:

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Dreams Take Flight Winnipeg - By submitting this form, your Agency or Organization has agreed to all the terms of the Child Selection tab on our DTF Winnipeg Website. Also all the information submitted in this form can be used by the Directors of DTF Winnipeg. As always, privacy is very important to us, no information is ever shared or given to any outside agencies.

Once Complete and Ready to Submit - Please Hit SUBMIT