Luggage With Love Delivery Request
Eligbility: Children must have some connection to Cleveland County. Request must be made within one week of placement or by case worker.

Deadlines: Forms submitted by 4pm will be delivered same day. Requests received after 4pm or on weekends will be delivered by the next business day.

Items Included: a suitcase containing: 2 tops, 2 bottoms, 3 pair of socks, 3 pair of underwear, 1 pair of pajamas, 1 pair of shoes, 1 coat/jacket/swimsuit (depending on the season), 1 blanket, 1 age appropriate book or toy, & 1 small personal hygiene kit. All clothing is new, no used clothing is included.
Placement First Name *
Name of the foster parent or kinship parent
Placement Last Name *
Child's Name *
KK or Court Case Number *
KK# from DHS paperwork of Court Case number if the case is tribal
Workers Name *
Name of DHS Social Worker
Date of Placement *
MM
/
DD
/
YYYY
Placement Phone Number *
Placement Email *
Placement Address *
Child Date of Birth *
MM
/
DD
/
YYYY
Child Gender *
Child Ethnicity *
Pant Size *
Shirt Size *
Shoe Size *
Underwear Size *
Diaper Size *
Special Needs or Comments
(i.e. Pull-ups, night diapers, bra's, ethnic hygiene items, etc.)
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