Referral Form

Click here to download the referral form. Complete and send via Fax or Email:

 

Fax: 301.420.7397
E-mail: info@takechargeprogram.org

 

 

 

 

 

 

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Some of our program sponsors are listed below
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2810 Walters Lane, District Heights, Md 20747 • Phone 301-420-7395 • Fax 301-420-7397
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