I'm interested in participating in PEPS Parents of Adolescents and Teens (PAT) program
First Name*
Last Name*
Please specify the age(s) of your child(ren):
Please indicate your availability for meeting times:
Weekdays - before 5 PM
Weekdays - after 5 PM
Weekends - Morning (before 12 PM)
Weekends - Afternoon (12-4 PM)
Weekends - Evening (4 PM or later)
No preference on meeting time - will make it work!
Questions and Comments
Submitting this form authorizes PEPS to send information and updates on our program for adolescents & teens and confirms your interest in participating.