Kanawha Dreamers Family Resource Center
Client Intake Form (Confidential)

Kanawha Valley Dreamers Family Support Center is a nonprofit organization serving Kanawha County, with a focus on the West Side. Generous foundations are covering the majority of the costs of the program you are about to attend, and we are required to report to them on the participation and outcomes resulting from this program. In order to receive this free or low-cost programming, they require that each participant fill out the entire attached form. All of this information will be kept CONFIDENTIAL and will not be used to identify you in any way. We will only need to contact you if the form is not completed in its entirety.