Watch the video before starting the enrollment process.  If you hit the submit button and do not receive "Thank you for enrolling....." your submission will not be accepted.  You must be sure to answer all required questions.  If something does not apply, do not leave it blank, instead use "NA" for non-applicable.
​***52 Week Domestic Violence participants must answer "Victim Information" Completely!
You MUST SUBMIT the form by pressing the green SUBMIT ENROLLMENT​ button.  A verification message (Thanks for submitting your enrollment!  We'll get back to you within 2 business days.) is displayed when the form is submitted. PLEASE ONLY SUBMIT THE ENROLLMENT FORM ONCE.
OPTIONAL: AFTER Submitting, save a copy for your records; right-click on form, press PRINT, then PRINT to PDF.  Save the pdf for your records. 
Terms Conditions Privacy Policy Document Link

You MUST SUBMIT the form by pressing the green SUBMIT ENROLLMENT​ button.  A verification message (Thanks for submitting your enrollment!  We'll get back to you within 2 business days.) is displayed when the form is submitted.  PLEASE ONLY SUBMIT THE ENROLLMENT FORM ONCE.
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OPTIONAL: AFTER Submitting, save a copy for your records; right-click on form, press PRINT, then PRINT to PDF.  Save the pdf.

Amy Christiansen
661-333-5545
P.O. Box 13488 ~ Bakersfield, CA 93389
[email protected]

Please use the Contact Us form for any correspondence or the Request Client Report for any client requests