Youth Registration for a Dress

Please Select If You Are a Group Home or Organization Registering 5 or More Recipients
I am registering multiple youth for a group home or organization
- I am registering multiple youth for a group home or organization
Name of Organization*
Contact Name at Organization*
First Last
Phone
Email*
Number of Spaces You Need to Reserve*
Preferred Time*
Please Complete this Section if You Are Registering Yourself or an Individual
Youth's Name*
First Last
Email to Receive Confirmation*
Phone (for Youth)*
Date of Birth*
Name of DCFS Child Social Worker
First Last
Preferred Time*

Please Select If You Are a Group Home or Organization Registering 5 or More Recipients