Birthday in a Box Request Form
The Birthday in a Box is a joy-filled celebration of a child’s birthday! It’s a keepsake box filled with the necessities for a birthday party and is being provided free of charge by Legacy Health Connections (www.lh-c.net) in partnership with The Birthday Party Project (www.thebirthdaypartyproject.org).

The boxes are available for children in foster care and kinship placements, as well as children adopted from foster care. Please complete a separate form for each child in your home that is in one of these categories.
Parent First & Last name *
Affliation *
Is this for a boy or girl?
Birthdate of Child *
MM
/
DD
/
YYYY
Email *
Address
Phone number *
Any comments/suggestions?
Submit
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