All Forms

Birthday Buddy Referral Form:

    Your Information

    Name (Required)

    Relationship to Child (Required)

    Email (Required)

    Cell Phone

    Home Phone

    Work Phone

    Address (Required)

    City (Required)

    State (Required)

    Zip (Required)

    Caseworker Information

    Caseworker Name (Required)

    Caseworker Phone Number (Required)

    Foster Child's Information

    Child First Name Only (Required)

    Child Date of Birth (Required)

    Age of Child on his/her Birthday (Required)

    Is this child likely to receive little or nothing for their birthday? (Required)
    YesNo

    How long has this child been in foster care? (Required)

    Birthday Information

    What would the child like for their birthday? Please be specific. Items must be valued at $25 or less. If clothing, please specify size. (Required)

    Describe the child's personality, talents and interests. Give specific examples and detail (Required):

    Release Form

    Do you agree to pick up the gifts in Kirkwood, MO or Bethalto, IL within 7 days of being notified? (Required)
    YesNo

    By completing and signing this application, I hereby request to enroll the foster child in my physical custody in the Foster & Adoptive Care Coalition’s Birthday Buddy program. 1. I understand there is no guarantee that my foster child will be matched with a Birthday Buddy. I understand that I will be contacted if the child is matched; 2. I understand that the Birthday Buddy program is completely dependent on the generosity and responsibility of others. I understand that even if my foster child is matched with a Birthday Buddy, circumstances beyond the Coalition’s control may prevent my foster child from receiving presents through the Birthday Buddy program. 3. If my foster child is matched with a Birthday Buddy, I agree to pick up the donated birthday presents in a timely fashion. I understand that I must pick up these birthday presents at one of the Birthday Buddy Coordinators’ homes in Kirkwood, Missouri or Bethalto, Illinois. 4. I promise to inform the Coalition if the foster child is removed from my physical custody before their birthday. 5. I promise that we will write a thank you note to the Birthday Buddy within 14 days of receiving the birthday present. I will send the thank you note to the Birthday Buddy Coordinator, to be forwarded to the Birthday Buddy. 6. I attest that the information in this Birthday Buddy application is true to the best of my knowledge and belief.

    By typing your full name below, you electronically acknowledge reading and understanding the above information. You state that all of the information you provided is true.

    Birthday Buddy Sign-Up Form:

      Foster Adopt Inquiry:

        If you're experiencing issues with this form, please call the Coalition at 314-367-8373 to inquire about becoming a foster or adoptive parent.

        Foster Friend Sign-Up Form:

          Your Name (required)

          Phone Number (required)

          Email (required)

          Address (required)

          State (required)

          Zip (required)

          Emergency Contact Phone

          Best Time to Reach You

          This information will be used to complete your background screening.

          Date of Birth

          If you’re a college student, what university do you attend?

          Employment Status:

          If you are employed, who is your employer?:

          Special skills/experience/services you are willing to share:

          How did you hear about Foster Friends?:

          Are you registered with the Family Care Safety Registry (FCSR)? (To check if you are registered with the Family Care Safety Registry, you can visit www.dhss.mo.gov/FCSR. Registration is required to become a Foster Friend.)

          If you are already registered with FCSR, do you give Foster & Adoptive Care Coalition permission to conduct a background screening?

          Permission to conduct a background screening:

          High School Senior Pictures Form:

            Little Wishes Referral Form:

              Child's Information

              Child First & Last Name (required)

              Child Date of Birth (required)

              Child Placement (required)

              Caregiver's Information

              Caregiver Name (required)

              Caregiver Email (required)

              Caregiver Address (required)

              Caregiver City (required)

              Caregiver State (required)

              Caregiver Zip (required)

              Caregiver Phone (required)

              Case Manager's(CM) / Adoption Worker's(AW) Information

              CM/AW Name (required)

              CM/AW Agency (required)

              CM/AW Phone (required)

              CM/AW Email

              Wish Information

              Wish Description (required)

              Why is Wish Important to Child? (required)

              Wish Cost (required)

              Date(s) of Activity (if applicable - i.e. summer camp dates)

              Wish Website (if applicable)

              Vendor Information (where the wish will take place or be purchased from)

              Vendor Name (required)

              Vendor Address

              Who will provide transportation for this class/activity?

              Who should the Coalition contact to facilitate this wish once it has been granted?

              Release

              By completing and submitting this application, I hereby request to enroll the foster child in my physical custody (or a child whose case I am managing) in the Foster & Adoptive Care Coalition’s Little Wishes program.
              1. I understand there is no guarantee that my foster child’s wish will be granted by a donor. I understand that I will be contacted when my child’s wish has been granted.
              2. I understand that the Little Wishes program is completely dependent on the generosity of others. I understand that even if my foster child’s wish is granted, circumstances beyond the Coalition’s control may prevent my foster child from receiving the wish through the program.
              3. I promise to inform the Coalition if the foster child is removed from my physical custody before the wish has been granted.
              4. I promise that if my child receives a wish that is tangible that he/she will take this gift with them if placement changes.
              5. I promise that we will write a thank you note to the donor within 14 days of receiving the little wish. I will send the thank you note to the Little Wishes Coordinator, to be forwarded to the donor.
              6. I attest that the information in this Little Wish referral form is true to the best of my knowledge and belief.

              Share Your Special Occasion Form:

                Third Party Fundraiser Form:

                  Volunteer Form: