CHAMPAIGN COUNTY FCFC REFERRAL FORM
Use the secure online referral form below. (A downloadable form is also provided if you would prefer to download, print and fill out the form before returning it to our office.)
Fields marked “required” must be completed before submission.
If you need assistance completing this form, please contact Champaign County Family & Children First Council at
937-653-4490 or email the office at [email protected].
Fields marked “required” must be completed before submission.
If you need assistance completing this form, please contact Champaign County Family & Children First Council at
937-653-4490 or email the office at [email protected].
| Champaign County Referral Form |
