Birthday Dreams (ages 1 to 12) CASEWORKER Important Information: ONE REQUEST PER CHILD Please submit your request no more than 4 weeks in advance of the child’s birthday. We will email when your child’s special gift is ready. Birthday package must be picked up at the Arizona Helping Hands warehouse during operating hours (Monday-Friday from 9am-4:30pm). You will be required to show us your “Notice to Provider” or other approved document and a Government issued photo ID. Our address is 3110 E. Thunderbird Rd., Suite 100 — Phoenix, AZ 85032 Limitation of one package per child per year WE CANNOT GUARANTEE THE AVAILABILITY OF ANY SPECIFIC ITEM, BUT WILL DO OUR BEST TO MAKE YOUR CHILD’S DAY SPECIAL! Caseworker Name*FirstLastEmail address*This field is REQUIRED for confirmations and notifications. Please check to make sure this is the correct e-mail address!Phone*AGENCY*UNIT*Terms of Service Agreement*I agree to the terms of serviceBy submitting this request you agree not to sell, barter or trade any item you receive from Arizona Helping Hands. Requests must be filled out entirely. Request must be in English. Your request is not guaranteed. DIGITAL SIGNATURE* Foster Child 1*FirstLast Relationship - Foster Child 1*Licensed Foster CareKinship Date of Birth - Foster Child 1*Foster Child 1 - Celebrating which birthday?*Please select123456789101112Gender - Foster Child 1*BoyGirl CLOTHING SIZESIF "YES" please provide shirt, pant and shoe size below: Your child's interest/activities - Foster Child 1*We make no promise of being able to accommodate your request, but will do our best to make your child's day special.BicycleCraftsDollsGamesPuzzlesSportsVideo GamesOtherBicycle HeightTraining WheelsYESNOFoster Child 1 - If SPORTS, which sport?*Video Game SystemIf OTHER, please describe - Foster Child 1* Foster Child 2*FirstLast Relationship - Foster Child 2*Licensed Foster CareKinship Date of Birth - Foster Child 2*Foster Child 2 - Celebrating which birthday?*Please select123456789101112Gender - Foster Child 2*BoyGirlYour child's interest/activities - Foster Child 2*We make no promise of being able to accommodate your request, but will do our best to make your child's day special.CraftsDollsGamesPuzzlesSportsOtherFoster Child 2 - If SPORTS, which sport?*If OTHER, please describe - Foster Child 2* Foster Child 3*FirstLast Relationship - Foster Child 3*Licensed Foster CareKinship Date of Birth - Foster Child 3*Foster Child 3 - Celebrating which birthday?*Please select123456789101112Gender - Foster Child 3*BoyGirlYour child's interest/activities - Foster Child 3*We make no promise of being able to accommodate your request, but will do our best to make your child's day special.CraftsDollsGamesPuzzlesSportsOtherFoster Child 3 - If SPORTS, which sport?*If OTHER, please describe - Foster Child 3* Foster Child 4FirstLast Relationship - Foster Child 4*Licensed Foster CareKinship Date of Birth - Foster Child 4*Foster Child 4 - Celebrating which birthday?*Please select123456789101112Gender - Foster Child 4*BoyGirlYour child's interest/activities - Foster Child 4*We make no promise of being able to accommodate your request, but will do our best to make your child's day special.CraftsDollsGamesPuzzlesSportsOtherFoster Child 4 - If SPORTS, which sport?* If OTHER, please describe - Foster Child 4* Foster Child 5*FirstLast Relationship - Foster Child 5*Licensed Foster CareKinship Date of Birth - Foster Child 5*Foster Child 5 - Celebrating which birthday?*Please select123456789101112Gender - Foster Child 5*BoyGirlYour child's interest/activities - Foster Child 5*We make no promise of being able to accommodate your request, but will do our best to make your child's day special.CraftsDollsGamesPuzzlesSportsOtherFoster Child 5 - If SPORTS, which sport?*If OTHER, please describe - Foster Child 5 Foster Child 6*FirstLast Relationship- Foster Child 6*Licensed Foster CareKinship Date of Birth - Foster Child 6*Foster Child 6 - Celebrating which birthday?*Please select123456789101112Gender - Foster Child 6*BoyGirlYour child's interest/activities - Foster Child 6*We make no promise of being able to accommodate your request, but will do our best to make your child's day special.CraftsDollsGamesPuzzlesSportsOtherFoster Child 6 - If SPORTS, which sport?*If OTHER, please describe - Foster Child 6SUBMITThis field should be left blank