The following statistical information is required by the United States Department of Housing and Urban Development(HUD). It is required that every social service agency that receives Community Development Block Grant(CDDG) funds fill out a monthly Direct Benefit Activities report. This information will be used to process our annual Grantee Performance Report.The information provided on this form is pertinent for future funding of this program. This program is for persons under the age of eighteen, this questionnaire must be filled out by a parent or legal guardian. THIS INFORMATION IS STRICTLY CONFIDENTIAL.

To see the full list of rules and requirements and to provide additional information about your child, download the complete registration pdf form below.