21st Century Animal Resource

21st Century Animal Resource and Education Services has provided character development and humane education programs for troubled teens and at-risk youth through the court systems as well as guidance counselor programs since 1997. We are now available across the nation. We are funded by private and government grants. We do not charge individual schools, cities, counties or states for services and programs we provide. We do, however ask for travel expenses to be reimbursed for first/initial visit. We require experienced security/supervision be provided at all times by your staff.

For consideration of 21st Century CARES providing your teen/youth program for troubled and at risk student programs, please fill out the following form. Form must be filled out completely.

Today's Date __________________

Contact Name ________________________

Name of Program __________________________

Contact Phone Number _________________________

Mailing Address _______________________________________________________

City, State, Zip Code ____________________________________________________

Contact Email Address _________________________________

Brief Description of Existing Program if available ___________________________________________

_________________________________________________________________________________

Number of Youth In Existing Program _____________________

How Long Has Existing Program Been Operating? _________________________

Number of participants you would provide us with ___________________

On which day/days __________________________________

During what hours ___________________________________

Will you provide Supervision Staff? _________________________

Will Each Session Be same Participants? ____________________

Will Each Session Be Mixed M/F? ________________

Does Our Staff Come To Location Provided by you? ___________________

If Not, What Alternatives Do We Have? _______________________________

Are You Able To Provide Trans;portation? ____________________

Approximate Date Preferred for Program To Begin ______________________

Estimated Duration (in months) of proposed program_________________________

Estimated Date Final Decision Willl Be Made _____________________________

Please Provide Any Additional Info You Fee We Should Know __________________________________

_________________________________________________________________________________

Once form is completed, please email it to 21stcares@citlink.net or mail to HUMANE EDUCATION 16224 N. Linda Dr. PO BOX 373 Dolan Springs, AZ 86441-0373 Attn: Randy Warner