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Forms:
Counseling Forms
-
Application for Services for an Adult
-
Application for Services for a Minor
- Print out the appropriate application form above.
("Adult"
for persons 18 and up. "Minor" for persons under the
age of 18.)
- Complete ALL paperwork!
(Exception: If you do NOT have insurance, skip the insurance page.)
- Return the completed paperwork, proof of income and deposit to
The Family Tree in one of the following ways:
| 1. FAX - |
"ATTN: Dee"
to (337) 981-2391 |
| 2. MAIL -
|
Dee Atkinson
4540
Ambassador Caffery
Building D,
Suite B220
Lafayette, LA
70508 |
| 3. DROP OFF IN
PERSON |
Monday
through Thursday -- 8am to 8pm
Friday --
8am to 4pm
The Family Tree
4540 Ambassador Caffery
Building D, Suite B220
Lafayette, LA 70508 |
- Make checks out to "The Family Tree"
- Visa or Master Card payments can be accepted by phone or in
person
- Cash Payments accepted IN PERSON ONLY!
- Submit proof of income in AT LEAST one of the following forms.
If you receive more than one, you are required to submit proof of
each that your household is currently receiving.
- A recent check stub
- AFDC (food stamps)
- SSI
- Child Support
- Student Loans
- Unemployment
- If you have Health Insurance, please include a copy of
the front AND back of your insurance card for benefit
verification purposes.
IMPORTANT!!!
→ PRIOR to
receiving services, the above information MUST be
completed and returned to The Family Tree |
| Education Forms: |
|
Class Registration Form
| 1. FAX - |
"ATTN: Dee"
to (337) 981-2391 |
| 2. MAIL -
|
Dee Atkinson
4540 Ambassador
Caffery
Building D, Suite
B220
Lafayette, LA
70508 |
| 3. DROP OFF IN PERSON |
Monday through
Thursday -- 8am to 8pm
Friday --
8am to 4pm
The Family Tree
4540 Ambassador Caffery
Building D, Suite B220
Lafayette, LA 70508 |
- Make checks out to "The Family Tree"
- Visa or Master Card payments can be accepted by phone or in
person
- Cash Payments accepted
IN PERSON ONLY!
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