Please fill out your JPO Program form below. Thank you!
Parent/Guardian First Name
Parent/Guardian Last Name
Child First Name (please include the name they prefer to be called)
Child Last Name
Email
Child Email Address (We find it most helpful when kids in the class can communicate with each other and will set up a class email group.)
Additional Parent Email Address
Chapter Name, if applicable
Age of Child
State and Country of Residence/ Time Zone
Parent Telephone Number (We use this to create WhatsApp or text groups and to provide needed communication to succeed with JPO.
Child Telephone Number (We will create WhatsApp Groups for the kids to communicate regarding JP experiences and events. This is particularly important for collaborative projects.)
What goals do you have for your child in this program?
What are three strengths that you would use to describe your child?
We will create small groups of students based on commonalities. What are some interests of your child?
Would you be interested in volunteering to lead small group discussions during our course sessions?
Please share anything else that you would like us to know about your child
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