Cake4Kids Cake Recipient Request Form

Please fill out all information

























Delivery Date (mm/dd/yy) e.g. 05/25/16. 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/yy) e.g. 05/25/10. Incorrect format will not be processed:


Age of Child:


Gender:

Preferred Dessert:

Preferred Color/Theme:


Food Allergies:

If other, please specify:


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