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<META NAME="description" CONTENT="Keep your children safe, stop governmental abduction of your children, self-help group.">
<META NAME="Keywords"    CONTENT="CPS,child safety, child protective services, help with CPS, cps help, county social services, social services, protect children, family rights, wrongful taking of child, dfcs, dss, dhs, adoption bonus, child protection laws, self-help, help yourself, cps help, child abduction, child, abduction, child abuse, abuse, CDSS, DSS, child advocate, advocate, advocates for children and families, advocates for children, family, child"> 


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<TITLE>Social Services Survey</TITLE></head>
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<center><table border="0"><tr><td>


<font face='Arial' size='+1' color='#000000'>

Social Services Survey

</font>


<br>
<SCRIPT LANGUAGE="JavaScript">
function validate(){
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<input type="hidden" name="order" value="80 81 82 83 104 105 106 107 108 ">
<input type="hidden" name="submit_url" value="http://theacf.org/onsubmit.html">
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<input type="hidden" name="name_80" value="Has Social Services forced seperation of your relationship ie: boyfriend,husabnd,wife, girlfriend etc.">
<tr><td>


<font face='Arial' size='2' color='#000000'>

Has Social Services forced seperation of your relationship ie: boyfriend,husabnd,wife, girlfriend etc.

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<input type="text" name="field_80">


</td></tr> 

<input type="hidden" name="name_81" value="Has Social Services Placed your children in different placements?">
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<font face='Arial' size='2' color='#000000'>

Has Social Services Placed your children in different placements?

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 <input type="radio" name="field_81" value="Yes">Yes <input type="radio" name="field_81" value="No">No


</td></tr> 

<input type="hidden" name="name_82" value="Has social services demanded psychological testing ?">
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<font face='Arial' size='2' color='#000000'>

Has social services demanded psychological testing ?

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</td></tr> 

<input type="hidden" name="name_83" value="Have any of your children been harmed, abuse, neglected or killed while under the custody and care of Social Services">
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Have any of your children been harmed, abuse, neglected or killed while under the custody and care of Social Services

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<tr><td>


<font face='Arial' size='2' color='#000000'>

Would you like to join our Email list?

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</td></tr> 

<input type="hidden" name="name_105" value="What is your Email Address? Be sure it is correct or we cannot contact you. ">
<tr><td>


<font face='Arial' size='2' color='#000000'>

What is your Email Address? Be sure it is correct or we cannot contact you. 

</font>


 </td><td>


<input type="text" name="field_105">


</td></tr> 

<input type="hidden" name="name_106" value="What State are you In?">
<tr><td>


<font face='Arial' size='2' color='#000000'>

What State are you In?

</font>


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<input type="text" name="field_106">


</td></tr> 

<input type="hidden" name="name_107" value="What County?">
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What County?

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<input type="text" name="field_107">


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<input type="hidden" name="name_108" value="Comments">
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<font face='Arial' size='2' color='#000000'>

Comments

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<textarea name="field_108" rows="4" cols="30"></textarea>


</td></tr> 

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<center>
<nobr>|<a href="index.html">Welcome</A>|</nobr>

<nobr>|<a href="about.html">About</A>|</nobr>

<nobr>|<a href="Disclaimer.html">Disclaimer</A>|</nobr>

<nobr>|<a href="complaints.html">Complaints</A>|</nobr>

<nobr>|<a href="forms.html">Court Forms</A>|</nobr>

<nobr>|<a href="help.html">HELP</A>|</nobr>

<nobr>|<a href="SWAP.html">Justice Now</A>|</nobr>

<nobr>|<a href="gpage5.html">Self-help</A>|</nobr>

<nobr>|<a href="links.html">Internet Links</A>|</nobr>

<nobr>|<a href="gpage2.html">The Project</A>|</nobr>

<nobr>|<a href="memorial.html">CaptivesofCAPTA</A>|</nobr>

<nobr>|<a href="gpage1.html">Delinquency</A>|</nobr>

<nobr>|Survey|</nobr>

<nobr>|<a href="contact.html">Contact Us</A>|</nobr>

<nobr>|<a href="form1.html">Join CSWAP</A>|</nobr>

<nobr>|<a href="Download.html">Download</A>|</nobr>

<nobr>|<a href="GovtAbuse.html">Govt Abuse</A>|</nobr>

<nobr>|<a href="GAChapter.html">Georgia</A>|</nobr>

<nobr>|<a href="ACFGA.html">ACF Georgia</A>|</nobr>
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