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Refer a Youth
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* Indicates required question
Email
*
Your email
Your Name
*
Your answer
Your Phone Number
*
Your answer
Your CPA Agency
*
Children's Connection, Inc.
NA
Arrow Family Ministries
UpBring
CHOL
TBGR
Texas Department of Family and Protective Services
FYi Center
DePelchin
The Bair Foundation
St. Francis
Other
Children's Hope
Buckner
Your relationship to the youth
*
Caseworker
FYi Caseworker
Friend
Teacher
Family Member
Counselor
Acquaintance
Other
Youth Name
*
Your answer
Youth Email
*
Your answer
Youth Phone number
Your answer
Youth Current Home Address
Your answer
Youth Current Home Type
Bio Family
Foster Family
Group Home
SIL
Independent Living
Couch Surfing
Homeless
Other:
Clear selection
Youth Current Needs ( Housing, Mentor, Transportation, Education, Rent/ Bill, Employement, Financial, Emotional, Other)
Your answer
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