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Case Manager Consent Form for Mentor Tutor Program

Company

Your Name *

Child Name *

Signature of DCS Case Manager *

Date *

Your Email *

I certify this is my electronic signature

I certify this is my electronic signature

Select application recipient

Arizonans for Children is a 501(c)3 (Tax ID # 02-0651198)

Qualifying Foster Care Charitable organization under the AZ Income Tax Credit Program therefore cash donations are entitled to a tax credit of up to $500 for single and $1000 for married couple filing joint return. You decide where Your tax dollars go!

Arizonans for Children relies solely upon the generosity and commitment of community members to provide critical services to foster youth; and we gratefully accept your tax-deductible financial and in-kind donations in support of our programs or operating expenses.

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ARIZONANS FOR CHILDREN, INC

2435 E. La Jolla Drive
Tempe, AZ 85282

480-838-0085

© 2002-2019 Arizonans For Children, Inc.