Recipient Request Form

Depending on the time of month and on federal and Jewish holidays when a request is received, care kits may take up to a few weeks to ship.

Recipient Request Form
Preferred Contact Method *

Personal Information

Please note: At this time Wrapunzel Foundation accepts female clients.
Requested Service/Program *
Please include Name, Phone number and Email
Please include Name, Phone number and Email
Leave us any requests here! We’ll do our best to match your request when we put together your Care Kit!
By Checking the box below, I hereby certify that the information given above is truthful and not used to defraud the organization. *