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At Home Application

  1. At Home app header

  2. What day do you prefer to be called?

  3. Frequency of Phone Contact

  4. Guardian header

  5. PRIMARY

  6. SECONDARY

  7. CARE PROVIDER

  8. The AT HOME Initiative has no cost, no meetings and no obligation. I authorize the Farmers Branch Police Department to add the above information to their AT HOME database and request that I be called as indicated in the application. I understand I may OPT-OUT at any time.

  9. Leave This Blank:

  10. This field is not part of the form submission.