For Oak Cliff - Client and Case Management

FOC Membership Application


You must be 18 years or older to complete this application.



Welcome! Thank you for your interest in becoming a For Oak Cliff Member! Before submitting an application, please take a moment to read the following information.

For Oak Cliff is a culturally relevant organization serving the South Oak Cliff community through four: Education, Community Building, Advocacy and Arts. The organization believes in 2-Gen, so we focus on creating opportunities for and addressing the needs of both children and the adults in their lives together with the aim of increasing social mobility and social capital. Our mission is to liberate Oak Cliff from systemic oppression.


For Oak Cliff's Core Values:

Courage | Liberation | Love | Wisdom


For Oak Cliff's 4 Pillars:

Education: We believe in creating a culture that sets higher expectations for the education of our children, and we believe that in order to create a true culture of education, we need to educate adults and children alike (2Gen).

Advocacy: We believe our systems are broken, and in order for us to have an equitable system that works for all, we have to change policy strategically.

Community Building: We believe in building a stronger community together by leveraging our strengths and providing avenues to use these strengths to support one another.

Arts: We believe art is the most creative expression of liberation. In order to awaken the artists of our community, we must increase access to the arts, artists, and avenues for creative self-expression.


For Oak Cliff's Culture Conduct Keys:

At For Oak Cliff, we believe that community building and relationships are a part of the organization's secret sauce and a critical way we all break free from systemic oppression. In addition, we ask that FOC Members become familiar with our Culture Conduct Keys as follows:

  • I agree to treat others with dignity and respect at all times.
  • I agree to extend grace, always.
  • I understand that collaboration is key and that a win for one is a win for all.
  • I agree to report inappropriate behavior and discriminatory, harassing, abusive, offensive, or unwelcome comments.
  • I understand that dishonesty of any kind is not welcome.
  • I agree to be open-minded towards community members with different experiences, perspectives, and backgrounds.
  • I understand that drugs, alcohol, and gambling are not allowed on FOC’s premises.
  • I agree to follow all FOC health and safety guidelines.



Please review our programs and select any you are interested in!

Member Information
* What program(s) are you interested in? Select all that apply:
Academic Enrichment
Adult Education (GED)
Community Engagement
Education
Employment Services
Enviornmentalist of Tomorrow
Farmers Market
Food Distribution
Girl Scouts
Membership
Phlebotomy
Snap Enrollment
Teen Intern
Want to Volunteer
Voter Pledge
* Are you registered to vote?
-- Select --
* Do you have voter identification?
-- Select --
* Do you know your voting location?
-- Select --
* Do you need a ride to the polls?
-- Select --
* Have you pledged to vote?
-- Select --
* Is everyone in our household registered to vote?
-- Select --
* Would you like to volunteer?
-- Select --
Food Distribution - Community Building
Do you have reliable transportation at this time?
-- Select --
Do you need grocery delivery to your home?
-- Select --
Rent/Utility Assistance - Advocacy
* Have you received rent/utility assistance from For Oak Cliff before?
-- Select --
If yes, please describe when you received assistance and which bills were paid.
* Please describe the circumstances that have led to you falling behind on your bills in as much detail as possible.
* Please describe which bills you are currently behind on and how much assistance you are requesting.
* Amount Requested
$
* Bill Due Date
* Interpreter
-- Select --
* Brief description of why you need assistance.
* I understand that by completing this application, it does not guarantee that For Oak Cliff will be able to provide rent and utility assistance and that a caseworker will reach out to complete my file.
GED Program
* Have you been a part of another GED program?
-- Select --
If yes, please name the program and give reasons for non-completion.
Would you prefer your GED experience be Virtual or Face-to-Face?
-- Select --
* What is the highest level of education that you have received?
* What is your goal/interest after receiving your GED?
* After receiving your GED, would you be interested in pursuing further education?
-- Select --
For Oak Cliff Volunteer Form
* What is your highest level of education?
-- Select --
* In volunteering for our tutoring program do you have a subject preference?
-- Select --
* Have you ever been convicted of a criminal offense (except for minor traffic violations)?
-- Select --
* Have you ever been convicted of a sexual offense, crime of violence, or offense relating to children?
-- Select --
* Have you ever been reported to a social services agency, child abuse registry or similar organization regarding abuse or misconduct involving children?
-- Select --
* Have you been subject of an investigation or allegation that resulted in a finding of sexual misconduct, sexual harassment or other immoral behavior or conduct involving adults or children?
-- Select --
If you marked “yes” to any of the questions above, we ask that you provide a complete explanation of the circumstances. If you feel that there are any extenuating circumstances, such as age at the time, please let us know.
* Are you willing to complete a background check if your volunteer role requires it?
-- Select --
OG's ProOG's Program age is 55+ and up
* Do you have a SmartPhone or a phone that can run Application software?
-- Select --
* Do you use your phone's Application software?
-- Select --
* Do you drive?
-- Select --
* Do you feel there is a range of health services available to you in your community?
-- Select --
Basic Information
* First Name
* Last Name
Contact Information
* Address
Address 2 (Unit Number)
* City
* State
-- Select --
* Zip Code
* Email Address
* Phone
Additional Information
* Date of Birth
* Gender
-- Select --
* Ethnicity
African American/Black
Caucasian American/White
Hispanic American/Latino
Asian/Pacific Islander/Alaskan/Native American
Other
Prefer not to answer
Maori
Middle Eastern
Native American
Pacific Islander
Southeast Asian
Marital Status
-- Select --
* Education Level
If currently enrolled, please select the highest level completed.
-- Select --
Are you a Veteran?
-- Select --
* How did you hear about For Oak Cliff?
Facebook/Twitter/Instagram
Flyers
FOC Staff Member
Family/Friend
News/Newspaper
Word of mouth
Website
Radio
TV
Walk-In
Todd Ambassador Program
Referred by a friend/community member
Other
Other
Which of the following apply to you
Are you interested in applying for snap.?
I have a child 0-5.
I have children who need enrichment.
I need medical insurance.
I receive SNAP benefits.
I want to register to vote.
I would like to obtain my G.E.D.
* Please select the school you CURRENTLY attend. Select "Other" if your school is not listed.
-- Select --
Other
Emergency Contact
* Full Name
* Relationship
* Phone 1
* Medical history or allergies to note
(Fill in n/a if none)
If there are additional members in your family, please enter using the 'Add another member' button.

Liability Waiver, Medical & Photo Release (You must be 18 years of age or older to sign below. Please have a parent or guardian sign for you if you are a minor under the age of 18.)



I attest that I am 18 years of age or over, or that I am a parent or guardian who is authorized to sign in on behalf of my child, and agree to the following: I hereby RELEASE, DISCHARGE AND AGREE TO HOLD HARMLESS For Oak Cliff, its officers, employees, agents, volunteers and assigns (hereinafter referred to as "For Oak Cliff") from and against any and all liability, claims, demands, and judgments which I may have, or which my heirs, executors, administrators, or assigns may have or claim to have against For Oak Cliff for any and all claims, demands, actions, and causes of action of whatever nature or character, known or unknown, which may be asserted by any person, firm, or corporation, whosoever claiming by, through or under me (or my minor children) for personal injuries, death, and/or property damage caused by or arising out of, my entry on to the property and/or participation in FOC sponsored activities including dangerous activities. I agree that if I (or my minor children) require rescue and/or emergency medical assistance and/or transport, I give my permission to For Oak Cliff to secure medical treatment for me (or my minor children) in the event that such treatment is needed I WILL PAY THE COSTS OF SUCH RESCUE AND/OR ASSISTANCE AND/OR TRANSPORT. I, or my heirs, will reimburse For Oak Cliff and/or others for the costs incurred in performing any rescue and/or assistance and/or transport on my behalf within thirty (30) days of receipt of the written demand. I hereby GRANT PERMISSION TO FOR OAK CLIFF TO USE PHOTOGRAPHS AND/OR VIDEO of me at any time in publications, news releases, online, and in other communications related to the mission of For Oak Cliff and understand and agree that I WILL NOT BE COMPENSATED in any way for the use of my name and/or likeness by For Oak Cliff. Because FOC works with minors, I hereby GRANT PERMISSION TO FOR OAK CLIFF TO SCREEN ME VIA SECURLY that screens for sex offenders. I have carefully read this RELEASE AND INDEMNITY AGREEMENT or had it read to me in a language that I fully understand and I understand all of its terms. I am signing voluntarily and with full knowledge of its legal consequences and of the personal risks to me and/or my minor children. I have not relied on any information from For Oak Cliff, its officers, employees, agents, volunteers or assigns in deciding to make this release and agreement.
* I understand that For Oak Cliff, at its full discretion, reserves the right to remove any individual from the premise that does not adhere to the FOC Culture Conduct Keys.
* Signature (Full Name)
* Date of Signature
01/21/2025

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