sk8shoes4kids.org referral form

Preview:

DESCRIPTION

Print out and fill in the application. You can send to to the head office in Castlegar, BC. We will contact you if you are approved.

Citation preview

Approved Date:

Name: Age:

Contact #: Shoe Size:

Explanation of how you/individual qualifies for shoes:

All information is confidential, unless you/individual signs a release of information form.All applications can be dropped off at Freedom Quest 349 Columbia Ave., Castlegar

Phone 250-304-2676 for more info.

Self Referral Professional Referral

Regional Youth Services

FREEDOMQUEST

CRITERIA: This program is designed for children and youth 18 yrs. & underwho cannot otherwise afford shoes due to financialmeans.Those that apply will not have a choice of shoe but willbe given new name brand skate shoes.

Street Dreamz Boardshop Inc. 7923 120th Street, Delta B.C. CANADA

Phone: 604 - 590 - 4553 Email:streetdreamz@hotmail.ca

Recommended