PAT Enrollment Form

 
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 Parent As Teachers Enrollment Form 

 
  Graphic logo for Parents as Teachers
   
  Please take a few minutes to complete this registration form. After you have submitted the enrollment form, Jamie Fink, the Parents as Teachers Coordinator will contact you to schedule a time for your initial visit.

In order to match you with a Parent Educator, we would appreciate your BEST estimate of when you will be available for visits until your child is 3 years old. On the form below, please mark the time you will be available for ongoing visits.

Please contact Jamie Fink, Coordinator, at jfink@usd232.org if you have any questions.

The information submitted through the enrollment form is confidential and is not used to discriminate services. Please complete the form to the best of your ability.
   
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Visits from 4-7 PM are for parents who both work full-time outside the home. If parents are available to visit before 4pm, they will be paired up with a parent educator sooner.
 
Visits from 4-7 PM are for parents who both work full-time outside the home. If parents are available to visit before 4pm, they will be paired up with a parent educator sooner.


   
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