Guardian ad Litem Foundation of Tampa Bay: Children's Needs Request Form
Please have your Child Advocacy Manager complete the below request form with required information. Emergency need requests will be reviewed immediately but no later than 48 hours after submission. Normalcy requests will be reviewed within 7 days. Please note: Requests over $500 require Committee approval and may take longer to process. Please plan in advance whenever possible.

Requests that will require multiple vendor payments should be submitted separately. Requests for multiple types of assistance should also be submitted separately. For example, Bailey needs a bed, grad fees, and hygiene items-this will require multiple payments and is likely to come from various grant sources so a form for each type is requested when possible.

If you have difficulty completing this form, please contact iamforthechild@galf6.org or your Child Advocacy Manager. When you have submitted the form, you will receive a confirmation email with your responses recorded.

Please forward that email to your CAM or to amyf@galf6.org. The form does NOT notify us of entries.

Email address *
Date Request Needed By (Our preferred payment method is credit/debit card. Please note checks are only cut on the 1st and 15th. Requests over $500 require additional approval and will delay processing.) *
MM
/
DD
/
YYYY
Type of Assistance Needed (If multiple children in the same family need the same type of item, you can fill this form out once. If you need multiple types of assistance please fill out a form for EACH TYPE of assistance needed for reporting purposes) *
Required
City & County Child Resides In (Gulfport, Pinellas) *
Your answer
Child Advocacy Manager Name *
Your answer
Child Advocacy Manager Email *
Your answer
GAL First Name *
Your answer
GAL Last Name *
Your answer
GAL Email Address *
Your answer
GAL Address *
Your answer
Child's First Name *
Your answer
Other Child First Names This Request Will Support (if supporting multiple children with same type of request in the household)
Your answer
Child's Last Name *
Your answer
Other Child Last Names This Request Will Support (if supporting multiple children with same type of request in the household)
Your answer
Number of Children This Request is Supporting *
Your answer
Type of Placement *
Placement Stability: How confident are you this child's placement is stable?
Not Very Confident
Very Confident
Number of Children in Home *
Your answer
Child's Age/Grade *
Please describe the child's need. Some case information is helpful here to help us report stories to funders. You must include info on how the child will benefit from the assistance. *
Your answer
How will this request be paid for *
Does this child have a trust fund or receive SSI or SSDI? *
Please provide who debit/check will be paid to, amount of payment, and address of vendor/payee *
Your answer
If check, will this be mailed to payee above or to GAL or other location? Please provide name and address if not the same as the above question. *
Your answer
Have you requested funding for this case before? If so, please give a brief statement of how we assisted. *
Your answer
Transportation is the responsibility of the applicant. Is transportation available for the duration of the program? *
Please provide any additional case information that will help us in approving this request or securing funding for the child.
Your answer
A copy of your responses will be emailed to the address you provided.
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