Young Parent Assistance Program
The Young Parent Assistance Program is a supportive initiative of WMCS Education & Community Services, Corp. designed to empower young parents ages 13–24 through access to essential baby care items, personal development opportunities, and employment readiness training. We understand the challenges of navigating parenthood at a young age, and we are here to help lighten the load. Our program provides:🍼 Monthly support packs with diapers, wipes, toiletries, and baby clothes (as available)🚍 Bus passes (as available) to assist with transportation💼 Employment Readiness Program to prepare young parents for the workforce🌱 Personal Development Workshops to build confidence and life skills🫶 Referrals to community resources and care coordination services. Este programa es para padres jovenes de 13-24 anos de edad.
Participant Name
Please enter the information of the person being referred, if this is a self-referral, just enter your information.
Name (nombre)
*
First Name
Last Name
Date of Birth (fecha de nacimiento)
*
/
Month
/
Day
Year
Date
How old are you? (Que edad tienes?) *This program is for young parents ONLY 13-24 years old (Este programa es para padres jovenes de 13-24 anos solamente.
Address (Needed if requesting a bus pass) (Dirrecion)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number (telefono)
*
-
Area Code
Phone Number
E-mail (correo electronico)
*
Which parent is seeking services (que pariente esta aplicando):
*
Mother
Father
Referring Agency Information
If you are from an organization or are an indivual referring someone, please enter your information in case we need to contact you for further information.
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Referring Agency Name
Program Services (Servicios Disponible)
*
Diapers, Wipes
Toiletries
Employment Assistance (resumes, applications, workshops...)
Personal Development (workshops, referrals,support groups)
If seeking diapers, please input sizes (si desea pampers, escribe el tamano)
Resource Interest Checklist - Please check off any resources or support you would like help with:
Parenting support (classes, support groups)
Food assistance/pantry resources
Mental health referrals
Housing or shelter referrals
Access to health services
Domestic violence or safety planning
Childcare information
Help with completing forms or applications
Legal advocacy or support resources
Immigration or citizenship assistance
Transportation assistance
Other
Do you need a bus pass? (Can be provided after July 1, 2025) (If yes, please make sure your address and contact info are completed above)
Yes
No
Where did you hear about us?
*
Please Select
Facebook
WMCS Website
Community Flyer
Referred
UC Network Night
If referred to us, who referred you?
Write name of Person/Organization
Do you have any access needs or accommodations you’d like us to know about?
*
Submit
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