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Thank you for your application to Willow Wish. We are dedicated to supporting the human and civil rights of women to choose a birth place supported by best evidence regardless of their ability to pay.
If you would like to apply for a $1500 gift that will be paid to the accredited Arizona birth center of your choice, please complete the following:
- Application Form - Willow Wish Gift Application - May 2018
- Personal Essay, Video, or Voice Recording:
- Why Willow Wish should grant me/us this gift
- Two most recent household income tax statements (2017/2016) to demonstrate household income
- If applicable: proof of enrollment in AHCCCS
- Release of Liability - Willow Wish Recipient Waiver