P.A.S.S Parenting Teen Girls with Jennie Schroll

~ Registration Application ~ Parents of Extreme Teens

with Jennie Schroll. Sponsored by the Alaska Center for Resource Families
6:00 to 7:30 p.m. Mondays on Zoom. January 6th- February 3rd 2025
Parent 1*

First NameLast Name
Parent 2

First NameLast Name
Will you be attending as a single or couple?

SingleCouple
Mailing Address

Line 1

Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail*
Are you a *
I am an adoptive parent.

YesNo
I adopted from:

Foster CarePrivate AdoptionInternational AdoptionOther
I am currently a parent to a pre-teen or teen:

YesNo
The youth currently lives:

In my homeIn residential or treatmentOther
Foster Parent Number

~ Registration Application ~ Parents of Extreme Teens