Live a Dream Application/Submission
Our mission is to strive to serve our residents to the best of our ability, to embrace their passions, and to give back a little piece of what they have given, and continue to give.
Type Of Dream
What Kind Of Dream Are You Interested In Pursuing
Please select...
Local Campus Dream (For Dreams Under $250)
Honor Flight
Bucket List Dream (For Dreams $250+)
DreamVR - Virtual Reality
*For More Information On Each Type Of Dream Please
Click Here
Please Select Campus
Please select...
IN-Anderson-Bethany Pointe Health Campus-112
IN-Avon-Wellbrooke of Avon-5166
IN-Batesville-St. Andrews Health Campus-120
IN-Bedford-StoneBridge Health Campus-115
IN-Bloomington HS-HearthStone Health Campus-5149
IN-Bloomington SC-Stonecroft Health Campus-5164
IN-Boonville-Woodmont Health Campus-110
IN-Carmel-Wellbrooke of Carmel-5165
IN-Columbus-Silver Oaks Health Campus-107
IN-Corydon-Harrison Springs Health Campus-2180
IN-Crawfordsville-Wellbrooke of Crawfordsville-5167
IN-Delphi-St. Elizabeth Healthcare Center-2134
IN-Elkhart-Greenleaf Health Campus-132
IN-Evansville NR-North River Health Campus-2186
IN-Evansville RP-River Pointe Health Campus-111
IN-Evansville WR-West River Health Campus -2142
IN-Ferdinand-Scenic Hills at the Monastery -303
IN-Ferdinand-Scenic Hills Care Center-303
IN-Goshen MW-The Maples at Waterford Crossing-124
IN-Goshen RW-The Residence at Waterford Crossing-2184
IN-Greencastle-Mill Pond Health Campus-119
IN-Greenfield-Springhurst Health Campus-125
IN-Greensburg-Aspen Place Health Campus-150
IN-Hanover-Thornton Terrace Health Campus-116
IN-Indianapolis AP-Arlington Place Health Campus-5160
IN-Indianapolis CL-Clearvista Lake Health Campus-5161
IN-Jasper-St. Charles Health Campus-108
IN-Kendallville-Orchard Pointe Health Campus-2185
IN-Kokomo WK-Wellbrooke of Kokomo-5168
IN-Kokomo WP-Waterford Place Health Campus-106
IN-Lafayette CS-Creasy Springs Health Campus-133
IN-Lafayette SL-The Springs at Lafayette-5162
IN-Lafayette SM-St. Mary Healthcare Center-2136
IN-Lawrenceburg-RidgeWood Health Campus-2143
IN-Lebanon-Homewood Health Campus-104
IN-Logansport-WoodBridge Health Campus-130
IN-Lowell-Cedar Creek Health Campus-156
IN-Madison-River Terrace Health Campus-2157
IN-Monticello-White Oak Health Campus-140
IN-Mooresville-The Springs of Mooresville-5174
IN-Muncie-Morrison Woods Health Campus-128
IN-New Albany AW-Autumn Woods Health Campus-105
IN-New Albany SC-The Villages at Historic Silvercrest-5151
IN-New Castle GO-Glen Oaks Health Campus-2153
IN-New Castle SL-Senior Living at Forest Ridge-2152
IN-Noblesville-Prairie Lakes Health Campus-141
IN-Peru-Blair Ridge Health Campus-144
IN-Petersburg-Amber Manor Care Center-304
IN-Princeton-RiverOaks Health Campus-117
IN-Richmond FP-Forest Park Health Campus-123
IN-Richmond SR-The Springs of Richmond-5173
IN-Scottsburg-Hampton Oaks Health Campus-121
IN-Seymour-Covered Bridge Health Campus-109
IN-Shelbyville-Ashford Place Health Campus-118
IN-South Bend-Wellbrooke of South Bend-5169
IN-Spencer-Owen Valley Health Campus-101
IN-Tell City-Oakwood Health Campus-103
IN-Terre Haute CC-Cobblestone Crossings Health Campus-129
IN-Terre Haute HC-Harrison's Crossing Health Campus-5163
IN-Valparaiso-Avalon Springs Health Campus-139
IN-Vincennes-BridgePointe Health Campus-131
IN-Wabash-Wellbrooke of Wabash-5170
IN-Warsaw-Paddock Springs Health Campus-302
IN-Washington-The Villages at Oak Ridge-305
IN-West Lafayette-Cumberland Pointe Health Campus-2135
IN-Westfield-Wellbrooke of Westfield-5171
KY-Bardstown-Cooper Trail Senior Living-233
KY-Cynthiana-Cedar Ridge Health Campus-114
KY-Danville-Walker's Trail Senior Living-231
KY-Harrodsburg-The Willows at Harrodsburg-2187
KY-Lexington WC-The Willows at Citation-2148
KY-Lexington WF-The Willows at Fritz Farm-2147
KY-Lexington WH-The Willows at Hamburg-2146
KY-Louisville ES-The Legacy at English Station-210
KY-Louisville FR-Franciscan Health Care Center-2137
KY-Louisville FS-Forest Springs Health Campus-2154
KY-Louisville GR-Glen Ridge Health Campus-126
KY-Louisville PT-Park Terrace Health Campus-127
KY-Louisville SB-The Springs at Stony Brook-175
KY-Louisville WP-Westport Place Health Campus-145
KY-Mt. Washington-Sanders Ridge Health Campus-176
KY-Shelbyville- Shelby Farms Senior Living-234
KY-Shelbyville-Shelby Farms Senior Living-234
KY-The Willows at Springhurst Pines-190
KY-Winchester-Boonesboro Trail Senior Living-232
MI-Battle Creek-The Oaks at NorthPointe Woods-501
MI-Belmont-The Oaks at Belmont-519
MI-Byron Center-The Oaks at Byron Center -2518
MI-Commerce-Westlake Health Campus-503
MI-East Lansing-The Willows at East Lansing-2507
MI-Grand Blanc-The Oaks at Woodfield-2505
MI-Howell-The Willows at Howell-2509
MI-Lapeer-Stonegate Health Campus-2506
MI-Macomb-Shelby Crossing Health Campus-2508
MI-Novi-Novi Lakes Health Campus-2510
MI-Okemos-The Willows at Okemos-2504
MI-Plainfield Charter Township-The Oaks at Belmont-519
MI-Romeo-Orchard Grove Health Campus-2512
OH-Bellevue-Willows at Bellevue-414
OH-Bluffton-Richland Manor-1407
OH-Colerain-Triple Creek Retirement Community-412
OH-Delphos-The Meadows of Delphos-407
OH-Englewood-Cypress Pointe Health Campus-416
OH-Findlay-The Heritage-408
OH-Fremont-Valley View Health Campus-403
OH-Gahanna-Taylor Springs Health Campus -436
OH-Genoa-Genoa Retirement Village-411
OH-Greenville-Village Green Health Campus-423
OH-Hamilton-Gateway Springs Health Campus-439
OH-Harrison-Harrison Trail Health Campus- 442
OH-Hillard-Norwich Springs Health Campus-437
OH-Kalida-The Meadows of Kalida-406
OH-Leipsic-The Meadows of Leipsic-409
OH-Lima SL-The Springs of Lima-433
OH-Lima-Springview Manor-410
OH-McConnelsville-Highland Oaks Health Center-2418
OH-Miami Township-Vienna Springs Health Campus-440
OH-Monclova-The Lakes of Monclova-2422
OH-New Albany SM-Smith's Mill Health Campus-438
OH-North Baltimore-Briar Hill Health Campus-415
OH-Ottawa-The Meadows of Ottawa-430
OH-Pickerington-Violet Springs Health Campus-421
OH-Springfield FG-Forest Glen Health Campus-401
OH-Springfield WG-Wooded Glen Health Campus-2429
OH-Sylvania-The Lakes of Sylvania-2427
OH-Tiffin-The Willows at Tiffin-435
OH-Union Township-The Glen-434
OH-West Chester-The Legacy at Liberty Ridge-211
OH-Willard-The Willows at Willard-2424
OH-Zanesville OB-The Oaks at Bethesda-2425
OH-Zanesville ON-The Oaks at Northpointe-2419
Dream Status?
Please select...
In Progress
Completed
Bucket List Dream Status?
Honor Flight Application Status
Please select...
Not Yet Filled Out an Application With Honor Flight (Different From Current Application)
Resident Has Been Approved By Honor Flight Chapter
Resident Is Waiting For A Seat On The Next Honor Flight
Dream Details
Please Note!
For Local Campus Dreams, please only come back to fill out this application once the Live a Dream has been
completed
. Please do not put
in progress
for the dream status.
Describe Dream Requested And What It Would Mean To The Resident:
*These Details Will Be Carefully Considered, More Details Will Increase The Chance Of Selection And Funding.
Please provide a Short Summary of the Dream
Example: Go Sky Diving, Visit Niagara Falls, or Attend Granddaughter's Wedding
Campus Dream
Category Of Dream
Please select...
Concert or Theater
Landmarks or Monuments
Family or Friends
Famous Person
Sky Related (Hot Air Balloon, Sky Diving, Flying)
Sporting Event
Other
If Other Please Describe:
DreamVR
DreamVR Experience
Please select...
At the Fork - At the Fork: Cattle
At the Fork - At the Fork: Dairy Cows
At the Fork - At the Fork: Eggs
Discovery - A Day in the Life on the Refuge
Discovery - A walk Among Giants: Muir Woods
Discovery - America's Best Idea
Discovery - Bode Miller: Birds of Prey
Discovery - Caring for Rhinos
Discovery - Charge Head First
Discovery - Cliffs of Moher
Discovery - Country Side Joy Ride
Discovery - Discover Princess Alaska Cruise Tour
Discovery - Dodge City Dirt Track Race
Discovery - Driving Through Abu Dhabi
Discovery - Elephants on the Brink
Discovery - England
Discovery - Enter the Motordome
Discovery - From Fishing to Ecotourism
Discovery - Get Ready for the Drop
Discovery - Gondola Ride in Venice
Discovery - Hawaii
Discovery - Highlight Reel
Discovery - Inside the Arctic Doomsday Seed vault
Discovery - Ireland
Discovery - Italy
Discovery - Japan
Discovery - Journey to the Edge of Earth
Discovery - Journey to the Edge of Space
Discovery - Jump Into the Unknown.
Discovery - Lion's Last Stand
Discovery - Mantas Flying on the Edge
Discovery - Mendenhall Glacier Helicopter Tour
Discovery - Most Dangerous Air Port
Discovery - Mt. Tamalpais
Discovery - On the Board With A Big Wave Pro
Discovery - Panda Playtime
Discovery - Playful Elephants Swim
Discovery - Protecting Costa Rica's Rain Forrest
Discovery - Protecting Ocean Anchor Species
Discovery - Protecting Pandas
Discovery - Pup's Eye View: First Half
Discovery - Rescuing Rhinos
Discovery - Route to Everest
Discovery - San Francisco
Discovery - Saving Threatened Species
Discovery - Science Sky Dive
Discovery - Shark Shipwreck
Discovery - Sharks Everywhere
Discovery - Spacewalk Mayday
Discovery - Sporting Abu Dhabi
Discovery - The Day the Asteroid Struck
Discovery - The Hive
Discovery - The Incredible Tech Inside Monterey Bay Aquarium
Discovery - There Are Actually Benefits to San Francisco's Fog
Discovery - Walk the Tight Rope
Discovery - Whale Sharks At Risk
Henry - Henry
Lady Liberty - Firework: Lady Liberty
National Geographic - Artic: Through the Ice
National Geographic - Carnivorous Glow Worms
National Geographic - Climbing Giants: Ep 1
National Geographic - Explore an Underwater National Park
National Geographic - Free Solo 360
National Geographic - Kamchatka Volcano Eruption
National Geographic - Monarch Butterfly Trail
National Geographic - Night Sky Over Joshua Tree National Park
National Geographic - Ride Through Space
National Geographic - Soar Above Bryce Canyon.
National Geographic - Swimming with Tiger Sharks
National Geographic - Victoria's Fall: The Devils Pool
Video 360 - Honor Flight Experience
National Geographic - Clearing Everest's Trash
Other
If you selected "other," please share the DreamVR experience you completed.
Number of Resident who experienced DreamVR
Please select...
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
Additional Comments/Story
If you have a story or additional comments to add about this experience, please submit those here.
Bucket List Dream
Which Of The Following Describes Your Dream The Closest
Please select...
Concert or Theater
Family or Friends
Famous Person
Landmark or Monument
Sky (Hot Air Balloon, Skydiving, Plane Ride)
Sporting Event
Other
If Other Please Describe
Recipient Information
Your Relationship To Resident
Please select...
Family Member
Campus LED
Campus Staff
Dream Recipient First And Last Name
Is the Resident in Need of Wheelchair access
Please select...
YES
NO
Resident Facility Type
Please select...
Assisted Living
Independent Living
Memory Care
Short-Term Rehab
Long-Term Rehab
Resident Birthday (If Known)
(MM/DD/YEAR)
Guardian Information
How Many Guardians Does This Resident Want To Experience this Dream With?
Please select...
0
1
2
Guardian One
Guardian First and Last Name
Guardian Email (If Known)
Relationship of Guardian
Please select...
Staff
Sibling
Child
Grandchild
Friend
Other
Guardian Phone Number (If Known)
Guardian Two
Guardian First and Last Name
Guardian Email (If Known)
Relationship of Guardian
Please select...
Staff
Sibling
Child
Grandchild
Friend
Other
Guardian Phone Number (If Known)
General Information
Submitter First & Last Name
Submitter Email
Campus Life Enrichment Director Email
Phone
Anticipated or Completed Date of Dream
Is this dream time sensitive for any reason?
Please select...
Yes
No
Why is this dream time sensitive
Please select...
Ticketed Event
Medical Reason
Family
Other
Other reason why this dream is time sensitive.
Honor Flight
Please Select Which Honor Flight Chapter Campus
Please select...
Honor Flight Bluegrass Chapter, Inc. (Louisville, KY)
Honor Flight Kentucky (Lexington, KY)
Greater Lafayette Honor Flight (Lafayette, IN)
Honor Flight Northeast Indiana (Huntertown, IN)
Honor Flight of Southern Indiana (Evansville, IN)
Indy Honor Flight (Plainfield, IN)
Flag City Honor Flight (Findlay, OH)
Honor Flight Cleveland (Madison, OH)
Honor Flight Columbus (Columbus, OH)
Honor Flight Dayton (Enon, OH)
Honor Flight Huntington (Huntington, WV)
Honor Flight Tri-State (Cincinnati, OH)
Mid-Michigan Honor Flight (Mecosta, MI)
Talons Out Honor Flight, Inc. (Three Rivers, MI)
Upper Peninsula Honor Flight (Gladstone, MI)
I do not know.
*If You Do Not See Your Honor Flight Chapter Listed Here, Please Contact Your LED Or The Home Office So That We Can Add It.
In which is the earliest war that this Veteran served?
Please select...
World War 2
Korean War
Vietnam War
Gulf War
Other
If Other Please Specify:
Do you know who the guardian will be?
Please select...
Yes
No
*Honor flight requires a guardian to attend that is not a spouse, do you know...
Guardian Information
Guardian First and Last Name
What Relation Is The Guardian To The Recipient? (If Known)
How Much Is The Guardian Fee?
Please select...
$400.00
$500.00
$600.00
I do not know the cost of the guardian
Other
If other, please state here:
Guardian Phone Number (If Known)
Guardian Email (If Known)
Misc.
I consent for Live A Dream to use this dream for marketing purposes.
Please select...
Yes
No
*Saying "No" does not disqualify this dream submission from happening.
I would like to remain anonymous to dream recipient.
Please select...
Yes
No
Optional Photos
Please feel free to attach any photos relevant to this application.
Contact Information