Please provide all pertinent contact and background information about the girl you are referring to The Friendship Club. We will use this to determine if she meets the initial criteria to receive our services. Please know that everything you include on this form will be kept confidential.
Please note that although we accept referrals all year, our active recruitment period is from January-April for girls to start the summer after school ends. Referrals received after May 15th are often too late to be enrolled for that year as new girls start their journey with us in the summer. If you have any questions, please don't hesitate to contact our Associate Director, Dena Valin, at (530) 265-4311 or firstname.lastname@example.org. Thank you for taking the time to complete this referral!