REQUEST FOR SUPPLIES AND SUPPORT
Please fill out this form with your family's information and the specific needs of your foster child(ren) after your placement has arrived. We hope to make your night just a little bit easier for you and a little bit happier for the child you've welcomed into your home!
Who is completing this request?
Please Select
Foster Parent
Kinship Parent
Social Worker
Agency Staff
Case Worker name
Case Worker email
Family Information
Foster Parent Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
County (Anne Arundel, Baltimore County, Baltimore City, Carroll, Harford, Howard, Montgomery & Prince George's County). *Please note that PG county families will receive a follow up email to pick up the care package.
*
How many people are in your household?
*
How many children are being placed today?
*
Please list children currently residing in your home (biological, adopted, kinship, and/or foster) NOT including the child/ren currently being placed. First name and age preferred. (We serve all children in your home in a unique way - they also make sacrifices as you welcome new children into your family)
Does anyone in the family have a food allergy?
*
Yes
No
Please explain.
Ages of Children Placed Today:
*
Infant
12-24 months
2-3
4-5
6-7
8-9
10-11
12-13
14-15
16-18
Foster Child's Information
BABY
Child's First Name
*
Gender
*
Age
*
Child's Race (This information helps us supply hair products)
*
Formula Type
*
Clothing Size
*
Preemie
Newborn
0-3 months
3-6 months
6-12 months
12-18 months
2T
3T
Diaper Size
*
Newborn
Size 1
Size 2
Size 3
Size 4
Size 5
Size 6
Pull-ups
BABY*
Child's First Name
*
Gender
*
Age
*
Race (This information helps us provide hair care products)
*
Formula Type
*
Clothing Size
*
Preemie
Newborn
0-3 months
3-6 months
6-12 months
12-18 months
2T
3T
Diaper Size
*
Newborn
Size 1
Size 2
Size 3
Size 4
Size 5
Size 6
Pull-ups
TODDLER/PRESCHOOLER
Child's First Name
*
Gender
*
Age
*
Child's Race (This information helps us provide hair care products)
*
Clothing Size
*
Does the child wear underwear/diapers/pull ups
*
Underwear
Diapers
Pull-ups
Underwear/Diaper size
*
Does the child need a bottle or sippy cup?
Bottle
Sippy cup
TODDLER/PRESCHOOLER*
Child's First Name
*
Gender
*
Age
*
Child's Race (This information helps us provide hair care products)
*
Clothing Size
*
Does the child wear underwear/diapers/pull ups
*
Underwear
Diapers
Pull-ups
Does the child need a bottle or sippy cup?
Bottle
Sippy cup
CHILD
Child's First Name
*
Gender
*
Age
*
Child's Race (This information helps us provide hair care products)
*
Clothing Size
*
CHILD*
Child's First Name
*
Gender
*
Age
Child's Race (This information helps us provide hair care products)
*
Clothing Size
*
CHILD**
Child's First Name
*
Gender
*
Age
*
Child's Race (This information helps us provide hair care products)
*
Clothing Size
*
TEENAGER
Child's First Name
*
Gender
*
Age
*
Child's Race: (This helps with hair & skin care products)
*
Clothing Size
*
TEENAGER*
Child's First Name
*
Gender
*
Age
*
Child's Race: (This helps with hair & skin care products)
*
Clothing Size
*
TEENAGER**
Child's First Name
*
Gender
*
Age
*
Child's Race: (this helps us with hair & skin products)
*
Clothing Size
*
Back
Next
Heading
Type a question
Please Select
Delivery Information
Please send me more information about:
Navigating WIC
Lice Care
African American Hair Care
Early Intervention Information
Anything we should know for delivery? Any other ways we can help you?
Have we served you before?
Yes
No
PLEASE UPLOAD A PICTURE OF YOUR FOSTER PARENT ID LETTER. (If your child arrived without a Foster Parent ID Letter, please e-mail the letter to baltimore@fosterthefamily.org once it arrives.)
Browse Files
Cancel
of
Submit
Should be Empty: