TLC Interest Form
fields in red are required

TLC primarily serves the counties of east central Kansas surrounding Kansas City. If you want information about agencies that serve other areas, please consult your phone book or public library.

Title
Your name
Spouse's name
Street address
City
State
ZIP
Home phone (please include area code)
Cell phone (please include area code)
Email address
I'd like to
know more about: 		PS/MAPP
 Foster Care
 General Information
Additional comments