Reference Form - Georgia Department Of Human Services Youth Empowerment Series Page 3

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Thank you for completing the DHS YES Reference Form.
Please submit the completed reference form using one of the methods below by
September 11, 2017. Note: Mailed forms must be postmarked by the application
deadline.
deshane.velasquez@dhs.ga.gov
E-mail:
Fax: 770-408-4928
Mail: ATTN: Déshané Velasquez
Georgia Department of Human Services
2 Peachtree Street, N.W., Suite 29.250
Atlanta, Georgia 30303-3142

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