Services Tracking Form Services and Supply Tracking Services and Supply Tracking Staff Member Name Staff Member Name First First Last Last Staff Member Phone Email * Complete All Fields That Apply Date of Service Type of Service Gift Squad Delivery (On-call)Gift Squad Delivery (General Gift Kits)Gift Squad Delivery (Helper's Gift Kits)A Place to Wait (Resupply)A Place to Wait (Install)Christmas on Your OwnFostered Start Scholarship (Ceremony)Fostered Gift Finder DeliveryGeneral Emergency AssistanceCommunity Event BoothSpeaking/Community EducationStaff TrainingCommunity ServiceFostered Gift Finder Search Location of Service Contact Name Number of Children Served Age Range of Child (If more than one child, check all that apply and list breakdown in details section) 0-1 2-4 5-9 10-12 13-17 17 or older Unknown Ethnicity of Child (If more than one child, check all that apply and list breakdown in details section) White/Caucasian Black/African American American Indian or Alaska Native Asian Native Hawaiian or Other Pacific Islander Hispanic or Latino Unknown Number of Helpers Served (If something other than kits was provided, please list in details section) Total Gift Kits Provided Type of Kits Provided (If more than one type, check all that apply and list breakdown in details section) Baby Kit Toddler Kit Elementary Kit Tween/Teen Boy Kit Tween/Teen Girl Kit General Hygiene Kit Comfort Kit School Kit Sensory Kit Activity Kit A Place to Wait Kit (Complete) A Place to Wait Kit (Partial) DCS/SRO Transport Kit Officer Kit Gift Squad On-Call Purchase Amount Gift Squad On-Call Approximate # of Items Average Cost per Child Christmas Christmas Purchase Amount Christmas Approximate # of Items Average Cost per Child APTW Initial Install APTW Supply Install - List Kit Items Delivered (Furniture etc. ) APTW Supply Install - Number of Items Provided (Toys, etc.) APTW Restock APTW Supply Restock - Number of Items Provided (Toys, etc.) APTW Supply Restock - List Kit Items Replaced (Furniture, etc.) Fostered Start Scholarship FSS Date Awarded Number Awarded Monetary Amount Awarded Total Cost of Fostered Start Items Community Education Training - Number Attended Training - Topic Required Training Optional Training Type of Emergency Assistance Provided Type of Fostered Gift Finder Search Requested Referral Source for Emergency Assistance or Search Additional Details or Notes If you are human, leave this field blank. Submit
