Case Worker Wish Form Case Worker Wish FormΔThis form is only for caseworkers of registered partner agencies only This Wish is pending approval by The Wish Project. You will be sent a confirmation when your wish has been approved. It can take up to 7 business days to to receive confirmation GUIDELINES - READ BEFORE PLACING REQUESTS Clients must reside in the Merrimack Valley area in order to receive items. Queen/Full Beds are reserved for couples. Twin beds are given to single adults and kids/teens. Newborn Baskets are given one month before or after the due date. They include: bottles, a blanket, newborn clothes, newborn diapers, wipes, bottle brush, and baby toiletries. Birthday Bags are party bags for children ages 1 to 17. Please do not request birthday bags for newborns. Birthday bags can be requested 1 month before the child's birthday or less than 1 month after. Microwaves are only being approved under special circumstances since we do not have enough for everyone. If you believe there is a special circumstance, please write it in the comments section. NO NEED TO PUT A REFERRAL FOR: Formula: we no longer give formula Clothes and Shoes: Anyone can come to get clothes and shoes every 3 months. They just need a photo ID. Diapers and Wipes: Any parent or guardian can come to get diapers and wipes every 30 days. They just need a photo ID and the birth certificate of the child. Any item not listed in the form: if an item is not listed, we do not have it. If you have any QUESTIONS, please email: jennah@thewishproject.orgCase Worker InformationCase Worker First Name Case Worker Last Name Agency (IF AGENCY IS NOT LISTED PLEASE EMAIL info@thewishproject.org) - Select -AgeSpanAllWays Health PartnersClarendon Early Eduction ServicesCoalition for a Better AcreCTI - HCECCTI - SheltersDCF LowellDwelling House of HopeFamily Services of the Merrimack ValleyHouse of HopeInternational Institute of New EnglandJRI LowellLCHC - ACOLCHC - PediLCHC - OBGYNLowell GeneralLowell Housing AuthorityMSPCCMatthew2535Mentor LawrenceMentor LowellMile's Day CareNFI LowellProject Kompass Inc.SISU-Lawrence YouthThom Anne Sullivan Center LowellTufts ACOValley CollaborativeVinfen - ACCS Lowell/Lawrence, TIP, PACT, Haverhill ClubhouseYWCA Northeastern MassachusettsCity Email Client Information DO NOT USE CHILDREN'S NAMES.Adult Client First Name Adult Client Last Name DOB (date of birth cannot be this year) Client City Adult Client 2 First name Adult Client 2 Last Name DOB (date of birth cannot be this year) Additional Adults Ethnicity - Select -CaucasionAsianHispanicNative AmericanAfrican AmericanFamily Status - Select -HomelessDisaster VictimPeople with DisabilitiesRecovering AddictGrandparent as ParentLow IncomeFoster ParentOtherAdults - Male Adult - Female Children - Boys Children - Girls Wish ItemsFor Full and Queens must have 2 adults in bed. Twins are given to single adults and children over 3. We do not give out box springs or metal frames alone, only sets. Please put the number of each bed size you need below.Beds - Baby Beds - Toddler Beds - Twin Beds - Full Beds - Queen Heater / Air Conditioning - Select -HeaterAir ConditioningHousehold ItemsChoose between sofa or loveseat, not both. Household kits include towels, bedding, toasters/toaster ovens, dishes, glasses, utensils, pots/pans, etc. Kitchen Table Dresser Sofa (For 3 or more people in the family) Love Seat (For 2 people or less in the family) Household KitsKitchen - Chairs Baby ItemsNewborn Baskets can be requested 1 month prior to birth & 1 month after birth.Baby Items Car Seat Carrier / Sling Stroller Double Stroller Play Mat High Chair Baby Bedding Diaper Bag Safety Kit Safety Gate Baby Bottles Baby SwingNewborn Basket Boy/Girl/Gender NeutralBoyGirlGender NeutralBaby Due Date (Can only receive NB Basket 1 month prior of after baby birth) Birthday Bag (Ages 1yr to 17yr.) - Select -BoyGirlDate of Birth (DOB) Comments Submit Form
