CCDN Forms and Documents for Programs and Services

Please see below the items needed for CCDN Programs

Life Services

  • Identification

  • Proof of Income

  • Proof of Residence

Referrals

  • Agency Information

  • Client Information

  • Narrative

Youth Mentoring

  • Parent Identification

  • Insurance Card for Child

  • Proof of Residence

  • Child's Report Card/Progress Report

  • Court Documents (if court ordered)

Inspire Youth Development

  • Parent & Student Identification

  • Insurance Card for Child

  • Proof of Residence

  • Child's Report Card/Progress Report

  • Withdrawal Letter from School

  • GED Certificate (if available)

  • Court Documents (if court ordered)

LearnWorks

  • Parent Identification

  • Insurance Card for Child

  • Proof of Residence

  • Child's Report Card/Progress Report

  • Court Documents (if court ordered)

CCDN Volunteer 

  • Parent & Student Identification

  • Insurance Card for Child

  • Proof of Residence

  • Background Check Form

  • Court Documents (if court ordered)

Please select from the forms below.  Here are the checklists for each area:

CCDN MOVEMENT

Be the change you want to see...in your home, school, church, and community!!!

Email

buildourcommunitywithcare@gmail.com 

Phone: (205)777-5894

Text:     (205)586-0740

Physical Location

 508 82nd Street N.

Birmingham, AL 35206

Donations Mail to: 

P.O. Box 610924 Birmingham, AL 35261

Registered Charity: 81-0955665

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