Elephant House Foundation Enrollment Interest Form

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Hey You! Thank you for your interest in our programs here at E.H.F.! We are really committed to helping every child and family by addressing trauma around them, but we're having fun and learning new things while we're doing it! The time has come to live "community" and build healthy relationships..we can help.

Child # 1 First & Last Name *

Child #1 Date of Birth *

YYYY

Child # 1 Gender *

Female

Male

Prefer not to say

Child # 1 School *

Child #1 School Grade *

Child #2 First & Last Name

Child #2 Date of Birth

YYYY

Child # 2 Gender

Female

Male

Prefer not to say

Clear selection

Child # 2 School

Child #2 School Grade

Parents' First & Last Name(s) *

Parent's Phone #(s) *

Parent's Email Address(es) *

Home Address *

Interested Start Date? If ASAP, put today's date. *

YYYY

What programs are you or your child interested in? Outlined on www.elephanthousefoundation.org *

Let's Taco Bout it Tuesdays (Youth)

Focused Groups (Youth)

Money 101 (Youth)

Introduction to STEM (Youth)

Spiritual Development (Youth)

Creative Expression (Youth)

Peer Recovery Support (Parents)

T.U.S.K. Talks (Parents)

Required

Do you have reliable transportation? *

Yes

Best Time to Contact You? *

Morning (8am-11am)

Afternoon (12pm-3pm)

Evening (4pm-7pm)

Required

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