Needs Form (Clothing & Items for Children, Teens - in foster care, and for Young Adults who have aged out of foster care)

"*" indicates required fields

If you are a foster caregiver, GAL, FSC, CPI, or Pathway young adult and needing Foster Closet's Free resource, fill out this form with the Name of Person making appointment and picking upfor child/children their care: (Please email us [email protected] once you have filled out your form.)*

Prefix First Last

Who is the caregiver, FSC worker, GAL making this appointment for this child? Who will be picking up the items for this child?

I am a:*

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Which location is this appointment for?*

Northeast Florida/Jacksonville

How many children need items?*

First Child Information (Or Pathway Needing Clothing)

Age*

Age Type*

Years

Months

Gender*

Male

Female

Clothing Size*

Shoe Size*

Any additional items needed: (Diapers, Bike Size, Items toys they like)

Birthday Coming up within the time frame of our free resource for your home? (if so, please give the (Month/Date/Year). If NOT needing a Birthday, please write N/A.*

We give 2 free wishes per child under 11. For those 12 and up, a Gift Card. However, we need them at FC before or on their birthday to receive their gifts.

Birthday Coming up within the time frame of our free resource for your home? And would like a Birthday Cake (if so, please give the (Month/Date/Year) If NOT in the time frame that the chid/children entered and not in need, please write N/A*

We give provide FREE Birthday Cakes if you would like per child (example: Child1/Child2/Child3/Child4) who is having a birthday within the time frame we help your home. When requesting a cake here, we will be sending you a Birthday Cake Wish Form to fill out and to email back to us within 1-2 weeks prior to the child's birthday. *unless the child is has entered within days of their birthday.

Second Child Information

Age*

Age Type*

Years

Months

Gender*

Male

Female

Clothing Size*

Shoe Size*

Any additional items needed

Birthday Coming up within the time frame of our free resource for your home? (if so, please give the (Month/Date/Year) If NOT, put N/A

We give 2 free wishes per child under 11. For those 12 and up, a Gift Card. However, we need them at FC before or on their birthday to receive their gifts.

Birthday Coming up within the time frame of our free resource for your home? And would like a Birthday Cake (if so, please give the (Month/Date/Year). If NOT, Put N/A

We give provide FREE Birthday Cakes if you would like per child entering your home who is having a birthday within the timeframe we help. When requesting a cake here, we will be sending you a Birthday Cake Wish Form to fill out and to email back to us within 1-2 weeks prior to the child's birthday. *unless the child is has entered within days of their birthday.

Third Child Information

Age*

Age Type*

Years

Months

Gender*

Male

Female

Clothing Size*

Shoe Size*

Any additional items needed

Birthday Coming up within the time frame of our free resource for your home? (if so, please give the (Month/Date/Year)

We give 2 free wishes per child under 11. For those 12 and up, a Gift Card. However, we need them at FC before or on their birthday to receive their gifts.

Birthday Coming up within the time frame of our free resource for your home? And would like a Birthday Cake (if so, please give the (Month/Date/Year)

Fourth Child Information

Age*

Age Type*

Years

Months

Gender*

Male

Female

Clothing Size*

Shoe Size*

Any additional items needed

Birthday Coming up within the time frame of our free resource for your home? (if so, please give the (Month/Date/Year)

We give 2 free wishes per child under 11. For those 12 and up, a Gift Card. However, we need them at FC before or on their birthday to receive their gifts.

Birthday Coming up within the time frame of our free resource for your home? And would like a Birthday Cake (if so, please give the (Month/Date/Year)

Northeast Florida Details

With what Agency are you licensed?*

When did each child come into your home? (Child #1_/Child#2_/Child#3_/Child#4_)*

Household Information

If Foster Home, Who is the Agency the caregiver is licensed*

** We are not able to help OMC unless the child/children are placed in Duval through FSS placement. Please let us know.

How many family members in total live in your home?*

How many times have you used Foster Closet for this placement?*

Since being in your home.

Case Manager/Counselor Information

Each Child's FSC worker (Case Manager's) AGENCY or DCF/CPI Info (Child#1_/ #2_/ #3_/ #4)_*

If there are multiple Caseworkers : Child 1_ / Child 2 _/ Child 3_ / Child 4_

Each FSC Worker (Case Manager's) or DCF/CPI's First and Last Name: (Child #1,#2,#3, #4)*

First & Last Name of Each Child's FSC worker (Case Manager's) or DCF/CPI Info (Child#1_/ #2_/ #3_/ #4)_

Phone Number for Each Child's FSC (Casemanager) / DCF CPI (Child #1 _/Child #2_/ Child#3 _/ Child #4_)*

Cell Number of Each Child's FSC worker (Case Manager's) or DCF/CPI Info (Child#1_/ #2_/ #3_/ #4)_

Each Child's FSC worker (Case Manager's) or DCF/CPI's Email: (Child #1, #2, #3, #4)*

EMAIL of Each Child's FSC worker (Case Manager's) or DCF/CPI Info (Child#1_/ #2_/ #3_/ #4)_

Confirmations

Documentation Required*

I understand that I must bring proper documentation in order to receive the items for my child(ren).

If you have forgotten what you must bring look at The Who Qualify's Page

Children Must Be Present*

I understand that tweens and teens must come in to Foster Closet and it will take on hour to shop.

Items Belong to the Child(ren)*

I understand that all items given by Foster Closet will Permanently go with the child(ren).

Please Note

To See what you will need to bring with you for your appointment, see “Who Qualifies”.
What do “We Provide”?
We will call or email you to schedule your appointment. Please look at our Contact Page to see our hours.
If you have tween or teen – Please remember they will need one hour to shop.
We help children in care: Foster, Relative and Non Relative
If you have more than 4 children, please fill out two forms.

**Supporting Foster Families with our for free resources, as they help “Look After” the children we serve in the foster care community of NEFL.**

Needs Form (Clothing & Items for Children, Teens – in foster care, and for Young Adults who have aged out of foster care)

First Child Information (Or Pathway Needing Clothing)

Second Child Information

Third Child Information

Fourth Child Information

Northeast Florida Details

Household Information

Case Manager/Counselor Information

Confirmations

Please Note