Name of Youth: Charles Deloach III
School/Grade Level: 8
Name of Youth: Charles Deloach III
Sex: Male
Parent/Guardian Name: Bridgette Bender
Contact Phone Number: 323-377-7712
Home Address: 14523 S. Budlong Ave #D
Person Referring Youth: Parent/Officer Anderson @ Peary Middle School
Why are you referring this person to our program: Has a bad attitude and Behavioral issues, acts out in class and has all failing grades, lies constantly