Form Test – Children's Guardian Fund

Guardian ad Litem request for Funds from the Children's Guardian Fund

While the Safe Children Coalition on behalf of the state provides daily needs for children in dependency, the Children's Guardian Fund may provide funding assistance for enrichment items.

Please complete this preliminary form to submit your request to the Children's Guardian Fund office:

GAL Name:*
CAM Name:*
# of children on this request:*
Please use numbers only (e.g. 1, 2, 5, etc.) to identify how many children will benefit from this request.
Child's name:*
FIRST and LAST name! If this request will benefit multiple children or a sibling group, list all of the children here.
Child's DOB:*
Child's age:*
Your email address:*
Request Amount:*
County where case originates:*
ATTENTION! Your computer may be auto-filling this field. United States or FL will not be accepted by CGF.
County where child is placed:*
ATTENTION! Your computer may be auto-filling this field. United States or FL will not be accepted by CGF.
Placement type:*
- relative care (grandparent, aunt, etc.)
- non-relative care (neighbor, friend, teacher, etc.)
- licensed foster home
- group home
- shelter
please select one of the options below
Placement zip code:*
GAL phone number:*
Description of how the funds are to be used (provide backup for camps, sports, etc.):*
Other sources explored?*
Does this child receive Social Security benefits?*
Check to be made out to:*
This is how the payee's name will appear on the check.
Check to be mailed to:*
This is the mailing label. Be sure to include the recipient's FULL NAME and ADDRESS in an address block format for timely delivery.
File Upload*
Please supply backup documentation, such as a PDF of the camp flyer, proof of cost of item, receipt, etc. This can be a PDF file, picture (.JPG, .GIF, .PNG, etc.), or a Word document. Your request cannot be processed without proof of item/activity cost.
Max. file size: 50 MB.
Before you hit submit, make sure that every field with an asterisk (*) has been filled in. If a portion of the form does not apply to your request, put n/a (not applicable). This includes all 5 lines of the "Check to be mailed to" section. If you leave a field blank, your form will not go through. Documentation can be submitted via this form, or by email to programs@childrensguardianfund.org.
Please allow two weeks to process your request. This request will be forwarded to your CAM for approval.