Monday, January 8, 2018

                         Family Resource Center

                      Because Children don't come with instructions

 

Parents as Teachers Home Visit Referral

Date: ________________

Referring Agency: _____________________________________________   Phone: _________________

Name of person making the referral: ______________________________  Email: __________________

Parent Name(s): _______________________________________________________________________

Child’s Name: _____________________________________Date of Birth: _________________________

Child’s Name: _____________________________________Date of Birth: _________________________

Child’s Name: _____________________________________Date of Birth: _________________________

Address: _____________________________________________________________________________

Phone: _________________________    Email: ______________________________________________

Best time to contact: _________________________________________

Notes regarding this referral: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

I authorize a referral to be made to the Family Resource Center for the purpose of follow-up on my family.  This may be done through home visits and/or phone contact.  I do understand that the Family Resource Center may reply back to the referring agency either by phone or paper on the services I receive.

____________________________________________________     ______________________________

Signature of client                                                                                           Date

____________________________________________________    _______________________________

Signature of witness                                                                                       Date

 

 

For Office use:  Date of initial contact with client: _______________   Date of initial visit: _____________


4800 Golf Road, Suite 450, Eau Claire, Wisconsin 54701
715-833-1735- Fax 715-833-1215- www.frcec.org

Wednesday, January 3, 2018



Sell Booklets Online with your unique link:

http://bit.ly/2EDsWY1

  • Email this link to your supporters! POST this link on Facebook, Pinterest and your Website!
  • We mail the booklets to your supporters FREE of charge. Your organization receives the same $5 for each booklet sold online! A check will be mailed to your organization for the total of your online sales at the end of the event.
  • Your organization's online sales count is updated weekly on the Sales Reporting page!
  • Visit the Online Selling link under My Tools on the Community Days website for more online selling ideas.
Bon-Ton - Bergner's - Boston Store - Carson Pirie Scott - Elder-Beerman - Herberger's - Younker's