*IMPORTANT NOTE: Filling out this referral form does not automatically mean you have been selected for a Makeover. At this time, KDM is an all-volunteer non-profit organization with no full-time staff. This means our primary reach is limited to Blount County and closely surrounding areas. If you are outside, but near, Blount County, TN, we will evaluate referrals on a case-by-case basis considering current financial resources and volunteer travel time for the project. As we grow, our reach will also expand so please be patient with us as we serve where God has called us. We do keep all referrals on file indefinitely. Thank you for your referral. Blessings. 

name of child *
name of child
address *
address
name of current parents/legal guardian
name of current parents/legal guardian
address *
address
phone number *
phone number
does child's current parents/legal guardian own or rent home? *
are the biological parents currently *