2022 Friends of Children Funding Request

PLEASE NOTE: ALL REQUESTS MUST BE APPROVED BEFORE ANY PURCHASES ARE MADE.

Date

Guardian ad Litem's Name*

First NameLast Name

Email*

example@example.com

Name of your CAM (Child Advocacy Manager). This person is a Guardian ad Litem Office employee who oversees a group of volunteers.*

GAL Phone number*

Area CodePhone Number

Are you a Guardian ad Litem Volunteer or Staff member?

Total amount of funding requested. *

Please note: Requests over $300 per child will require full vote of the Board of Directors.

ALL REQUESTS MUST BE APPROVED BEFORE ANY PURCHASES ARE MADE.

**** FOR CAMPS, LESSONS, OR ACTIVITY REQUESTS: A survey will be emailed to you for completion by you or the Caregiver. Quarterly results are required by the Foundation that granted us funding for these activities. A separate email with the link to the form will be sent to you after approval of your Camp, Lesson, or Activity request. Thank you for your cooperation.

Name of first child. Other children can be listed below*

First NameLast Name

Age/Gender*

Funding requested for this child*

Name of second child

First NameLast Name

Age/Gender

Funding requested for this child

Name of third child

First NameLast Name

Age/Gender

Funding requested for this child

Name of fourth child

First NameLast Name

Age/Gender

Funding requested for this child

Length of time in care*

Type of care*

Please indicate the city, state or county where the child is located*

What is needed for the child or children*

Describe the reason you are requesting that Friends of Children fund this need.*

What type of financial assistance is the caregiver currently receiving? *

Additional Comment:

Once your funding request is approved, Friends of Children can send items directly to caregivers, or we can send you a check to make the necessary purchases. We do not send money up front to caregivers. If you or the caregiver purchase the items upfront, we will reimburse for the approved amount once receipts are received.

*** RECEIPTS ARE REQUIRED FOR ALL PURCHASES MADE ***

Person receiving the check or receiving delivery of items ordered.*

First NameLast Name

Address for the check or where we can send items ordered. *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone number of person receiving check or delivery of item ordered. *

You may attached a file here for items to order:

By clicking the submit button below you agree to the following:

GALs or CAMs requesting funding for camps, sports, activities, and lessons will be required to complete a survey to assess any caregiver-reported improvements in the child's self-esteem, social skills, and reduction in anger outbursts following the activity. Friends of Children received a grant to provide this funding, and we are required to report behavioral improvements quarterly. Kathy Matson will contact you with the survey.

I understand by accepting Friends' funds, I am responsible to provide Friends with receipts for the merchandise purchased and to return any excess funds.

Original receipts should be mailed to:

Friends of Children of Brevard
P.O. Box 360915
Melbourne, FL 32936

Phone: 321-247-9717

Your cooperation in submitting these original receipts within 10 days of purchase is appreciated, but must be submitted within 30 days.

Funds may only be used for the purpose intended.

If you have any questions or need to edit, please email: mail@FriendsofChildrenofBrevard.org.

Friends of Children Funding Request Form