Request Enrollment Info
Employment Opportunities
General Inquiries & Donations
Just enter your info below!
Name *
Email *
Learn How to Get Your "Good" Son Back in 90 Days!
First Name *
Last Name *
Email *
Phone *
State *
How did you hear about us?
How did you hear about us?
Advertisement
Arabian Horse Times
Direct Mail
Online - AOL
Online - Google
Online - MSN
Online - Other Website
Online - Yahoo
Referral - From Counselor
Referral - From Customer
Yellow Pages
Boy's Name *
Boy's Age *
Please select a boy's age
12 or younger
13
14
15
16
17
18 or older
Your Relationship to Boy *
Please select your relationship
Parent
Step-parent
Guardian
Relative
Friend
Counselor
Probation Officer
Choose the #1 concern
you have about your boy:
Please select one concern
ADD
ADHD
Adoptive or foster home issues
Argumentative
Attachment disorder
Bad friends
Bipolar
Defiance
Depression
Experimenting with drugs
Gang activity
Laziness
Low self-esteem
Lying
Oppositional defiance disorder
Rebellion
Running away
Skipping school
Sneaking out
Stealing
Program Choice
Please select a program
3 months
6 months
10 months
Not sure
Do you need financing? *
Yes
No
How familiar are you with the different programs options
(wilderness programs, boarding schools, therapeutic boarding schools, boot camps, military schools)?
Please select one
Not familiar at all
Somewhat familiar
Familiar
Very familiar
How soon are you looking for placement? *
Please select one
Immediately
Near Future
Just looking at options
Arivaca Ranch, LLC © 2007-2009 |
Site Map