To complete an application with one of our staff, you can: *fill out the form below and click send *stop in at our office at 101 5th Avenue Belle Fourche or call 1-800-598-5859 *email our Family Community Specialist directly We will need to document the following information when you apply: 1) Child's age - verified by birth certificate or medicaid card. 2) Income of adults in the home - verified by last years tax statement or pay stub. You may also use this form for questions or comments. Thank you! We can't wait to hear from you!