Request Form Please enable JavaScript in your browser to complete this form.Request For: *Education FundSummer FundHelp FundRequestor *CASAAttorneyProbation OfficerSocial WorkerEmpower Yolo StaffRequestor Name *FirstLastEmail *Phone Number *Street Address *City *Zip Code *Child's Name *FirstLastChild's Age *123456789101112131415161718192021Grade *Pre-KindergardenKindergardenFirstSecondThirdFourthFithSixthSeventhEighthNinthTenthEleventhTwelfthPost SecondaryCase Number: *If no case number is available please type in “None” Agency *CPSProbationEmpower YoloBrief description of child's living situation and reason for request *Date of Request *Amount Requested *Please Describe the Request *Submit
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