Refer a B Happy Trip B the Difference

Who is eligible for a B Happy trip?

Young adults with a Neurofibromatosis diagnosis, age 13 to 30, living in the Contiguous United States. Self-referrals or referrals from immediate family members are not eligible.

Application Process

Please fill out the following form to the best of your knowledge – thorough information will assist immensely. Please note, this is the first step in the B Happy selection process – it is not confirmation that your nominee will be selected for a trip. The information you provide will be received and you will be contacted by a B the Difference team member.

All nominations are confidential.

Your Information
Your Name*
First Last
Your Email*
Your Phone*
Relationship to Individual*
Self-referrals and referrals from immediate family members are not eligible.
Nominee Information
Name of Nominee*
First Last
Gender of Nominee*
Age of Nominee*
Hometown/State*
Nominee Contact Information (parent of guardian if under 18)
Parent/Guardian Name*
First Last
Email*
Phone*
What inspired you to recommend this individual?*
Has this individual been granted a Make-A-Wish?*
Please add any information you feel we may need to know about this individual for our selection process. (Optional)
How did you hear about B the Difference? (Please provide as much detail as possible)*

Your Information

Nominee Information

Nominee Contact Information (parent of guardian if under 18)