Parenting an Adolescent or Teen? Interested in finding connection, resources, and community? Need support in specific topics around adolescent parenting? Please provide more information below so we can offer program options to best suit your needs.
 
 
 
I'm interested in participating in PEPS Parents of Adolescents and Teens (PAT) program
 
 
 
First Name*
 
 
 
 
Last Name*
 
 
 
 
Email*
 
 
 
Zip*
 
 
 
 
 
 
 
Please specify the school grade(s) of your child(ren):
 
 
 
 
Child(ren) Grade in School
 
 
 
 
 
 
Please indicate the choices of PAT topics that would be most relevant for you as a teen parent
 
 
 
PAT Topics - select your top 4 choices
 
 
 
 
 
Please indicate the choice of PAT group that would be most relevant to you for attending in 2023
 
 
 
PAT Group Choice
 
 
 
 
 
 
 
Please indicate the timeframes that you would consider for joining a PAT group
 
 
 
PAT Group Timeframe
 
 
 
 
 
 
Please indicate your availability for meeting times:
 
 
 
 
PAT Group Meeting Time
 
 
 
 
 
Questions, Concerns and Comments
 
 
 
 
 
 
I am unable to join a PAT group at this time but I will consider joining other PAT program formats in the future.
 
 
 
PAT Format Choice
 
 
 
 
I have a friend who might be interested in participating in PEPS Parents of Adolescents and Teens (PAT) program
 
 
 
Friend's Email
 
 
 
 
 
 
Submitting this form authorizes PEPS to send information and updates on our program for adolescents & teens and confirms your interest in participating.