Caseworker Request for Assistance Form

2026 RFA form

Please carefully read our updated Request for Assistance Policies and Procedures. Signing this form below acknowledges that you have accepted these terms and expectations.  Requests can only be submitted by a caseworker or through a social service agency on the client’s behalf. Thank you!

  • The Giving Tree of Temple Beth El seeks to fulfill all appropriate requests for assistance which are submitted to our organization by a caseworker or social service agency. However, there may be circumstances in which we will be unable to fulfill a request or part of a request.  You will be notified via email in these situations.
  • Only fully completed requests will be considered.  Requests with missing information will not be fulfilled.
  • A request form will need to be completed for each individual client.  We will no longer accept requests for multiple individuals on one form.
  • Each case worker will be limited to five individual requests per month.
  • You may not submit more than one request per individual per year unless you are requesting school uniforms, school supplies or holiday gifts. (If a request was made for John Doe on 5/01/26, another request for him can not be submitted before 5/01/27)
  • Once a completed request is submitted, a confirmation email will be sent to you.
  • Please allow 7-10 days for us to fulfill the request. You will be notified by email when the items are ready for pick up.
  • You will pick up your requested items from The Giving Tree located at: 1101 Holland Drive, Suite 7, Boca Raton FL 33487
  • Pick up times are ONLY on Tuesdays and Thursdays between 1:00pm and 4:00pm, and Wednesdays between 8:00am and 11:00am.
  • Items will be held at our workspace for two weeks.  If items are not picked up within this time frame the request will be cancelled.
Acknowledgement

Case Worker Information

Recipient Information

Recipient Gender:

Recipient Request

The recipient is requesting:

About Clothing Sizes:

  • If the recipient is between two sizes, please write the larger size.
  • If the recipient is a XS, S, M, L, XL or XXL, please also include a number size, for examples for: Small - 5
  • For men's pants, please write the number size, for example: 36x32 (if it is known)
These sizes are:
These sizes are:
These sizes are:
Child needs a Backpack:
Car seat needed:
Stroller needed:
Personal Hygiene Items needed (limited quantities available):

Additional Information:

Is this a Holiday Gift Request?
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