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Referral Inquiry Form

This inquiry form is the first step to receiving a wish – it is not confirmation of eligibility for a wish. Your information will be forwarded and you will be contacted by a member of our wish-granting team.

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Your information

We value your privacy and will not share your personal information.

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Please confirm your email address. We want to make sure we can respond to your request.

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Make-A-Wish® Central & Western North Carolina
1131 Harding Place
Charlotte, NC 28204
(704) 339-0334
Toll Free (877) 677-9474
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