For entry into Destiny, Power, & Purpose programs.

For entry into the District of Columbia programs.

For entry into Prince George’s County programs.

currently enrolled in program, but need to register.

Registration is a requirement for entry into Destiny, Power, & Purpose, Inc. programs. Please complete the form and return to:

Destiny, Power, & Purpose, Inc.
4719 Marlboro Pike
Capital Heights, MD 20743


Complete List of Forms

Mail or Fax the forms to the following:
Destiny, Power, and Purpose, Inc.
4719 Marlboro Pike – Suite #101
Capital Heights, MD 20743

District of Columbia
  • DC Form 1
  • DC Form 2
  • DC Form 3
  • DC Form 4

Prince George’s County

  • State and Care Coordination Referral Form
  • Release and Consent to Participate in PGC State Care Coord Services
  • PGC State Care Coord Program Application
  • Authorization for Release of Confidential Info about Alcohol or other
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