Birthday Box Request
Please complete the form below and let us know what is needed for the upcoming birthday party! Birthday boxes will be delivered by Friday afternoon.
Are you requesting a birthday box for a child in any of these placements? If yes, please select one:
*
GOH Youth Shelter
Foster Home
CWOP
Kinship
Other
No, Child is not in CPS Care
Child's Information
Child's Name:
*
Child's gender?
Female
Male
When is the Child's Birthday
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
How old is the child turning?
*
What day will the party be held on?
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Birthday Party Details
What is the child's favorite color?
*
What is the child's favorite snack/type of chips?
*
What is the child's favorite beverage ?
*
What is the child's favorite candy?
*
What is the Child's favorite movie/cartoon character ?
*
What is the child's desired gift?
*
This helps us decide what gift to get for the birthday kid.
How many children will be attend the birthday party?
*
This helps us ensure that we have enough goodie bags for everyone at the party.
Requestors Information
Please complete this section to allow us to contact you with updates about your birthday box.
First Name
*
This allows us to know who we should contact when the box is ready.
Best contact Email
*
We will use this email to contact you with updates about your birthday box.
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Please be on the lookout for an email from A Step Together. We will be contacting you with updates regarding your birthday box as well as your preferred method of delivery/Pickup.
Submit
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