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COMMUNITY ACTION AGENCY'S VITA PROGRAM IS ONLY FOR RESIDENTS OF MONTGOMERY COUNTY

THIS VITA PROGRAM IS ONLY FOR RESIDENTS OF MONTGOMERY COUNTY WITH AN INCOME OF $64,000 OR UNDER.  ALL TAX RETURNS ARE BEING PREPARED USING AN IN-PERSON OR VIRTUAL MODEL.
1. Select location2. Join Waiting List

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Tax Site Address Main Office
1401 Rockville Pike, Suite 320
Rockville,MD 20852
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Waiting List

Please complete the following. If you have any special instructions please note them in the Special Instructions box.
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Taxpayer Name or E-mail
Please enter your information below (required fields are in bold)
* Home Location
   
* First Name
   
Middle Name
   
* Last Name
   
* Address
   
Address 2
   
* City
   
* State
   
* Zip Code
   
* Daytime/Cell Phone
   
Evening Phone
   
Cell Phone
   
* E-mail
   
* Interpretation Needed? 
   
* Text Messages Okay
Yes   No   
* E-mail Okay
Yes   No   
* Mail Okay
Yes   No   
* Gender
   
Allow to Log In
Yes   No    If the client has made more than 1 appointment
If the client has missed more than 3 appointments
Special Needs
    Special Needs
Multiple Appointments or 3 or more No Shows
    Client who has booked more than 1 appointment
Client who has more than 3 no shows
Referred By
   
Customer ID
0    
Waiting List Information
Location No Preference
Number in Group 1
Notes

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