Comfort Cases Agency Orders - 2024 Question Title * 1. Agency Full Shipping AddressPlease complete all contact information. Contact Person at Agency * Agency * Address * County * City/Town * State/Province * -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code * Email Address Phone Number (xxx-xxx-xxxx) Question Title * 2. Is your location a residential address? Yes No Question Title * 3. Does your agency support youth in foster care? Yes, we directly support youth transitioning into foster care. No, we support youth in crisis. Please explain below. Please explain how you support youth in foster care. Question Title * 4. Please tell us how your past orders of Comfort Cases have impacted the youth that are supported through your agency. Question Title * 5. ALL AGENCIES ARE REQUIRED TO PAY FOR FULL SHIPPING COSTS:You may place multiple orders per month. Enter the number of sizes needed (Newborn - Adult 2XL) ESTIMATED COST: 100% between $120-220 depending on location, 50% between $60-110.If we do not have the exact size that you are requesting in our inventory, we will automatically apply the closest size to your request. Female Comfort Cases Male Comfort Cases 0-3 Months 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 0-3 Months Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 0-3 Months Male Comfort Cases menu 3 Months 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 3 Months Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 3 Months Male Comfort Cases menu 6 Months 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 6 Months Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 6 Months Male Comfort Cases menu 9 Months 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 9 Months Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 9 Months Male Comfort Cases menu 12 Months 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 12 Months Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 12 Months Male Comfort Cases menu 18 Months 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 18 Months Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 18 Months Male Comfort Cases menu 2T 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 2T Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 2T Male Comfort Cases menu 3T 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 3T Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 3T Male Comfort Cases menu 4T 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 4T Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 4T Male Comfort Cases menu 5T 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 5T Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 5T Male Comfort Cases menu 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 6 Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 6 Male Comfort Cases menu 7 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 7 Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 7 Male Comfort Cases menu 8 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 8 Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 8 Male Comfort Cases menu 10 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 10 Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 10 Male Comfort Cases menu 12 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 12 Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 12 Male Comfort Cases menu 14 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 14 Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 14 Male Comfort Cases menu 16 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Male Comfort Cases menu AXS (Female) 18/20 (Male) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 AXS (Female) 18/20 (Male) Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 AXS (Female) 18/20 (Male) Male Comfort Cases menu AS 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 AS Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 AS Male Comfort Cases menu AM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 AM Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 AM Male Comfort Cases menu AL 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 AL Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 AL Male Comfort Cases menu AXL 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 AXL Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 AXL Male Comfort Cases menu A2XL 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 A2XL Female Comfort Cases menu 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 A2XL Male Comfort Cases menu Do not Need PJs At This Time (Type N/A) Question Title * 6. Our Comfort Cases are backpacks filled with brand new items including pajamas, a blanket, stuffed animal, dental kit, toiletries, and socks. Additional age-appropriate items are included in each case.If we do not have the exact size that you are requesting in our inventory, we will automatically apply the closest size to your request.How many total cases are you ordering? The form does not automatically total, so please add up your quantities carefully. Baby Cases: Newborn - 2T Under 10 Cases: 3T - 10 Over 10 Cases: 12 - A3XL TOTAL Number of Cases Question Title * 7. Comfort XLs:Our Comfort XL is a large 32-inch duffel bag that folds up very compact and truly replaces the trash bag. **Due to the rising costs of shipping, supplies, and the Comfort XL’s (each about a $75 value,) we are asking our agency partners to cover the full cost of shipping when ordering CXL’s. 1 Box - 25 CXL's 2 Boxes - 50 CXL's No CXL's at this time. Question Title * 8. Payment for FULL Shipping Costs:Estimating Your Shipping Costs: Each order of 50 Comfort Cases will cost between $120-220 depending on your location in the country, 50% cost would be between $60-$110. Each box of Comfort XL's will cost about $20-40 per box depending on your location in the country due to the heavier weight.NOTE: If you are UNABLE TO PAY for shipping at this time, please CANCEL your order and place a new order when you have funding. Thank you for understanding. We will pay 100% of the shipping costs - an invoice will be sent to me for payment We will pay 50% of the shipping costs - an invoice will be sent to me for payment Order Complete
