Referral Form

P.O. Box 421107, Dallas, TX 75342 214.630.1667

Attitudes & Attire™ Referral Form

Agency Name: ________________________________________________________________________________________

Counselor/Case Manager Name:___________________________________________________________________________

Text Box: Phone Number:________________________________________________________________________________________ Email:_______________________________________________________________________________________________ Client Name:________________________________________________ Workshop Date:____________________________ (please print)

Please review the following referral criteria with your client:

Client is seeking employment or advancement.

Client will attend workshop at above date beginning at 9:00 a.m. If client arrives after 9:30 a.m. we will re-schedule for another date. The dressing ends at 4:00 p.m.

Client has not attended the A&A program within the past 12 months.

Client is capable of interacting in a group of women from diverse backgrounds and is at least 16 years old.

*Note: Clients must bring a SACK LUNCH to the workshop. We do not leave the building for lunch.

___________________________________ ___________________________________

Client Signature Counselor/Case Manager Signature

* Please give a copy of this form to your client for the directions and sack lunch reminder.*

Please call 214.630.1667 to register your client.

This reservation MUST be confirmed by calling 214.630.1667.

Directions to Attitudes & Attire™

We are located in the World Trade Center at 2050 N. Stemmons Freeway. Please enter the building through the main entrance and wait around the black fountain in the lobby. Our phone number is 214.630.1667.

From Stemmons Freeway (I-35):

Take the Market Center Blvd. exit. The World Trade Center is located in between Oak Lawn and Market Center Blvd, (please see attached map) look for the large, brown, 15 story building. From Market Center Blvd., take the first right (at the light) into the World Trade Center Parking lot.. Park in front of the International Floral & Gift Center (low building, to the right of the World Trade Center). Use the main front entrance to the World Trade Center. Walk straight down the hallway where you will come into the main lobby. Please wait inside the lobby around the black pool fountain and someone will be out to get you.

From the Dallas North Tollway:

Exit Wycliff (just beyond the last toll booth). Turn right on Wycliff to Harry Hines and then right on Harry Hines. Turn left on Market Center and take your first left into the World Trade Center parking lot. Park in front of the International Floral & Gift Center (low building, to the right of the World Trade Center). Use the main front entrance to the World Trade Center. Walk straight down the hallway where you will come into the main lobby. Please wait inside the lobby around the black pool fountain and someone will be out to get you.