Nominate or Submit Your Child

October 20th at 11:59pm is the deadline. You can either mail-in your application or proceed to use the online form below.

At Jay’s Juniors, we believe every child facing serious health challenges deserves an escape and a chance to create lasting memories. If you know a family with a child who could benefit from our program, we encourage you to support and advocate for them by letting them know about Jay’s Juniors and encouraging them to apply. By spreading the word, you’re helping us bring hope and happiness to those who need it most. Our team carefully reviews each application to ensure we can make a meaningful impact in the lives of these deserving families. Please share this information with the family, and encourage them to fill out the form below if they wish to apply.

The following application should be filled out by the parent or guardian of the child for whom the trip is intended. Please complete all sections of the application to be considered. The trip is a 5-day, 4-night experience at Walt Disney World in Orlando, Florida, from December 3rd through 7th. There are no alternative dates or times available. Families selected for the trip will be notified on October 22nd, 23rd, and 28th during normal business hours.

Jay’s Juniors 2024 Application Details

We created Jay’s Juniors this year with the goal of making life a little bit better for children in
Metro Detroit. Our mission is to provide a fun-filled environment for a few days for kids who suffer from chronic or terminal illnesses and their families by paying all expenses for a trip to Walt Disney World in Orlando, Florida.

Criteria
  • Nominated child must be age 3-17 (at the time of the trip)

  • Be diagnosed with a chronic or terminal illness, an impairment from a birth defect or physical challenge.

  • Must reside in the WNIC listening area
  • Show a financial need (otherwise unable to afford the trip)

Items to include with your application

  • Copy of birth certificate to verify age
  • Include photocopy of the first page of the most recent tax return for the family
  • If applying for more than one child, please fill out separate applications for each
  • Photo of child applying

Siblings (between the ages of 3-18) and legal guardians that reside in the home in which the child lives will be invited on the trip. Applications must be received by 11:59pm on Sunday, October 20, 2024.

This form is currently closed for submissions.