To complete an application with one of our staff, you can:*fill out the form below and click send *stop in at our office at 101 5th Avenue Belle Fourche or call1-800-598-5859*email our Family Community Specialist directlyWe will need to document the following information when you apply:1) Child's age - verified by birth certificate or medicaid card.2) Income of adults in the home - verified by last years tax statement or pay stub. You may also use this form for questions or comments. Thank you!We can't wait to hear from you!
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