Share Your Story

Your Name*
Your Child's Name*
Email Address*
Here is a little about my child and our experience with Kids Who Count.*
How have your child and family been impacted by the services you’ve received from Kids Who Count?*
What changes have you seen in your family and child as a result of services?*
I agree to allow Kids Who Count to use my image and/or words in print, video, photographic, internet or other electronic mediums to advance the mission of Kids Who Count.
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Upload a Word Document (if applicable)
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