Cinderella Project Foster Parent & Case Manager Referral Form

    Who is the individual submitting this referral form? (Required)

    Student Name (Required)

    Name of High School (Required)

    Student Cell Phone

    Email Address Student Checks Regularly (Required)

    Case Manager Name (Required)

    Case Manager Cell Phone Number (Required)

    Case Manager Email Address (Required)

    Foster Parent Name (Required)

    Foster Parent Phone Number (Required)

    Foster Parent Email Address (Required)

    Who will transport the student to the Cinderella appointment? Case manager, foster or other (please specify)? (Required)

    Grade (must be 11th or 12th - student must show student ID to prove age): (Required)

    Date of Prom

    Estimated Dress Size (Required)

    Appointment Time (Required)
    1) If you are a foster care case manager who wants to bring more than 1 student to an appointment, please contact Fonda, our Cinderella Coordinator, directly at 314-952-8268 to get a special appointment time.
    2) If you do not need a group appointment, please have the student choose 3 preferred appointment times. If the student is a size 0 or a size 16 or larger, keep in mind that earlier appointment times offer the best dress selection. The student’s assigned appointment time will be emailed to the student and the referring person (case manager or foster/adoptive parent).
    10:00am - Saturday, February 2911:30pm - Saturday, February 291:00pm - Saturday, February 292:30pm - Saturday, February 294:00pm - Saturday, February 2912:30pm - Sunday, March 12:00pm - Sunday, March 13:30pm - Sunday, March 14:30pm - Monday, March 24:30pm - Tuesday, March 34:30pm - Wednesday, March 4
    For more information, contact Fonda Richards at 314-952-8268.