Demystifying Schools & Services

Select Your County *
Focus on Freedom currently provides services within Winnebago, Outagamie, Calumet, and Fond du Lac counties. Please contact your service coordinator for additional guidance.
Who Is Completing This Form?*

Parent / GuardianCoordinator

Parent / Guardian
Parent Full Name*

Parent First NameParent Last Name
Parent Email*
example@example.com
Is the Parent Address the Same as the Child’s Address?

YesNo
Parent Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Parent Preferred Contact Method*

PhoneEmail
Service Coordinator
Coordinator Name*

Coordinator First NameCoordinator Last Name
Coordinator Email*
example@example.com
Coordinator Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.

Session