Interested in connecting with other families to find resources, support, and opportunities to learn in community?  Join a PEPS Group for Parents of Adolescents and Teens (PAT)! Unable to join an upcoming PAT Group? Fill in this interest form to share input and help PEPS create PAT Program options that will better suit your needs.
 
 
 
First Name*
 
 
 
 
Last Name*
 
 
 
 
Email*
 
 
 
Zip*
 
 
 
 
 
 
 
Name(s) of your child(ren)'s school(s)*
 
 
 
 
 
 
Please specify the school grade(s) of your child(ren):
 
 
 
 
 
 
Please indicate the discussion topics that you’re most interested in learning more about. (Select up to 4 topics)
 
 
 
 
Please indicate the PAT Group type you would prefer.*
 
 
 
 
 
 
 
 
Please indicate the PAT Group format you would prefer.*
 
 
Please indicate the timeframes that you would consider for joining a PAT Group.*
 
 
 
 
Please indicate the meeting times you would prefer.
 
 
 
 
Please indicate the factors affecting/influencing your ability to participate in a PAT Group? (Select all that apply)*
 
 
 
 
I would be interested in supporting the PAT Program in the following ways:
 
 
 
 
Questions, Concerns and Comments
 
 
 
 
 
 
Submitting this form authorizes PEPS to send information and updates on the Parents of Adolescents & Teens (PAT) Program.