Cake4Kids Cake Recipient Request Form

Please fill out all information to request a cake from Cake4Kids. If you need any help with completing this form, please refer to our Cake Request Guidelines.

Delivery Date (mm/dd/yyyy) e.g. 05/25/2017. Incorrect format will not be processed:

Cake Delivery Time (minimum of 2 hours, e.g. 3-5 pm):

Case Worker Name:

Agency Contact Email:

Child Date of Birth (mm/dd/yyyy) e.g. 05/25/2010. Incorrect format will not be processed:

Age of Child (on this birthday):



Preferred Dessert:

Preferred Flavor:
***Note: We do not supply Ice Cream cakes or Fresh Cream Frosting.

Preferred Color/Theme:

Food Allergies:

If other, please specify: