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BOARD OF DIRECTORS
Programs and Events
21st Century Brookland-Lakeview COLA Program
AARP Digital Skills Ready @ 50 Plus
Diabetes Intervention Program
Diabetes Intervention Program – Spanish
Mental Health Awareness Training Initiative
Mental Health Awareness Training Initiative Spanish
Summer Camp 2023
WE CARE 2: Clothing and More
Helping Families Intake Form
Date of Birth
Best Contact Number
Do you have a child currently attending a school in Lexington School District Two?
If yes, which school?
Are you currently employed?
What is the name of your employer?
In what county do you reside?
What is your household size?
What is your monthly household income?
What is the source of your household income?
What assistance are you seeking?
Select All That Apply
Finding a job
Creating a monthly budget
Legal services for dispute with landlord
Assistance with scheduling medical appointment for a child
Mentor/tutoring/homework assistance for a child
Counselor/Social Worker Comments
Thank you for submitting your intake form for assistance and support. The Brookland-Lakeview Empowerment Center and the Siemer Institute: Two-Generation Approach Social Worker, Mrs. Theresa Hill, will contact you very shortly.
There was an error trying to send your message. Please try again later.
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