Beyond the Moon is a non-profit organisation that is committed to safeguarding and respecting the privacy of all its website users. We ensure that the personal information you provide to us is treated confidentially. Accessing and using this website, as well as sending this form duly filled in, imply the acceptance of the Beyond the Moon privacy policy.
We only accept applications for European-based families. Before completing and sending this form, please thoroughly read the information in the questions hereunder:
Who qualifies according to our selection criteria?
Who can nominate a family with a sick child?
* compulsory fields
Beyond the Moon n.p.o.
Zandstraat 27K
B-2223 Schriek (Belgium)
T: +32 (0)15 23 36 82
E: website@beyondthemoon.org
IBAN: BE41 0014 7129 7010
BIC: GEBABEBB
National Number: BE 0873.856.370
Beyond the Moon - Website sponsored and hosted by Black Lion