Client Application

In an effort to provide the most effective programs, we require all clients to complete this application. Information contained on this application will remain confidential. Please, complete this application in its entirety before submitting it to Project Walk-Kansas City. After your application is reviewed, our office will contact you by e-mail or phone. The completion of this application does not guarantee your participation in our program. ***IF THERE IS A BLANK SPACE IN THIS APPLICATION, IT NEEDS TO BE FILLED IN. INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED***

Click to Download our Client Application

*Note: Because we send our client's billing invoices via email, please put your billing email address above.