Referral Form

The Carlton Locksley Bennett Foundation, Inc.

CLBF Partnerships Affecting Change in Teens Program

Dear Referring Personnel:

Thank you for your interest in referring your young person to participate in the CLBF PACT Program. The Selection Committee is committed to engage the young person in a productive way and wants to make sure the young person is a right match for the program. Below are 6 eligibility criteria. The young person will be chosen if they meet at least 3 out of 6 criteria. The young person must meet the 3rd criterion. We wish you and your young person all the best.

Sincerely,

Deborah Washington, M.Ed., C.R.C., LMH

Program Advisor, CLBF, INC.