General Smile Request Application

If the Smile Applicant is under hospice care, please have the hospice social worker complete a Hospice Application. The Hospice Application is processed more quickly and available online for the social worker ONLY to submit.

Dear Smile Applicant,

Josh’s Smile Beyond the Chair is a foundation granting Smiles for adults with a life limiting illness and a life expectancy of 12 months or less.  We do our very best to grant Smiles for those unable to fulfill them on their own.

We are a small nonprofit organization based in Port Orchard, Washington. By working together, with people helping people, we will make every effort to make your Smile come true.

• If you are under hospice care, please have your hospice representative submit a Hospice Application.
• Please read this form very carefully and follow all the instructions to complete the steps necessary to make a Smile come true.
• You will find many answers to your questions in our Frequently Asked Questions section.
• Please submit all required information; incomplete applications will be denied.

• Requests for adults with chronic illnesses- with the exception of individuals with a clinical prognosis of 12 months or less
• Surprise Smiles (those requests that have not been made known to the recipient)
• Legal assistance
• Hunting
• Funeral arrangements or posthumous requests
• Travel outside the United States
• Requests from individuals living outside the USA
• Cash/Financial assistance
• Reimbursements for completed Smiles
• Property or home improvements or repairs
• Medical treatment/supplies/equipment /transport
• Any Smile request deemed offensive, inappropriate or inconsistent with the values of our organization