GAL Funding Request

Email *

Name of Guardian ad Litem *

First

Last

Date of Request *

Phone Number *

Amount Needed *

Case File Number *

Child's First Name and Last Name Initial Only *

GAL Address *

Line 1

Line 2

City

State

Zip Code

Country

Shipping Instructions *

Option 1: No shipment required Option 2 Ship to GAL Option 3 Ship to Caregiver Option 4 Ship to CAM

Date Needed (Format: 01/01/2018) *

Have you spoken with your Child Advocate Manager (CAM) in search of available funding or other resources to meet this request? *

Yes No

Reason for Funding Request *

Items Detail *

If your request is $500 or more, what other funding or support sources have been explored.? Please include contact information for followup. *

GAL7 Foundation, Inc. prefers to make checks payable directly to the vendor from an invoice. Exceptions can be made on a case by case basis in order to meet the needs of the child. It is important we have an invoice/receipt for all expenditures to be in compliance with IRS regulations. ENTER Vendor to be paid below *