Cake 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.










Agency Delivery Location:












Case Worker Name  (first, last)


Case Worker Email







Delivery Date Requested  (mm/dd/yyyy)
(e.g., 08/25/2018)


Delivery Time Requested  (minimum 2 hour window)
(e.g., 3-5 pm, 8-10 am, 1-4 pm, etc.)


Child's Date of Birth  (mm/dd/yyyy)
(e.g., 08/25/2010)


Child's Age
***Enter age child is turning on this birthday


Child's Gender:

Occasion:

Preferred Dessert:

Preferred Flavor:
***Note: We do not supply sweets with cream cheese, whipped cream, ice cream, tres leches, cheesecake, flan, or custard

Preferred Color/Theme:


Food Allergies:

If "Other" Food Allergies, please specify here