enrollmentform by HC120807081227

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									          FATHERS WITH VOICES CONSULTING SERVICES
                       Enrollment Form
                          336-899-6941
                    www.fatherswithvoices.info


Name
Address
Tel/Cell#
E-mail address
Referred by-

1) Are you separated/divorced?

2) What type of case are you involved in?

3) Is your case within the state you reside in or where your child resides?


4) How many children are involved and what are their ages?


5) Do you need assistance in finding legal representation?


6) Are there any existing restraining orders?


7) Are you paying child support at this time?


8) Do you have an attorney?


9) Are you having difficulties with your attorney?


10) What do you need from our services?-please be as detailed as possible


11) What is the best way in which you would like to communicate with the
program?

								
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