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Improving Lives

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Booster to Belts Completion Form

Thanks for completing the Booster to Belts program in your community! Please fill out the form below. When this form is complete, DCCCA will process your reimbursement (if applicable). If you completed the program in more than one elementary school, please fill out a separate form for each school. Kindergarten-3rd grade students at each school must receive the presentation for the speaker reimbursement. Haven’t completed the Booster to Belts program yet? Go HERE to apply!

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Headquarters

3312 Clinton Parkway
Lawrence, KS 66047
Phone: 785.841.4138 Fax: 785.841.5777 Email:
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DCCCA provides social and community services that improve the safety, health, and well-being of those we serve.
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