Parent Advocate Request
Please complete the following form to request more information about securing a parent advocate. Advocates are available to assist clients and their families as they learn the ins and outs of the often difficult and confusing Individualized Education Program process. The advocate ensures that parents and children receive fair treatment, and works with school staff to ensure that The Arc clients and their families understand the programs and resources that are available to them.
Name of Child
*
First Name
Last Name
Name of Child's School
*
Does your child currently have an Individual Education Plan?
*
Please Select
Yes
No
I am not sure
What is your child's current grade level?
*
Child's Date of Birth
*
-
Month
-
Day
Year
Date
Name of Parent/Legal Guardian
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Tell us why you are requesting assistance.
*
Submit
Should be Empty: