The Harmony Kids Foundation Program Application Form

Thank you for your interest in applying for our services and resources. The Harmony Kids Foundation offers programs and products focused on lifelong, healthy self-regulation skills for children of all ages who face physical, mental, emotional, and social barriers to wellness. The Foundation also provides parents, caregivers, educators and healthcare providers (in-person and virtual) educational workshops, courses and resources designed to support and improve the health and well being of children and youth in their communities. 

Sign in to Google to save your progress. Learn more
Email *
Please provide contact information for the main point of contact requesting programs/services from The Harmony Kids Foundation. 


First and Last Name (please include preferred pronouns) *
Role/Title (For ex: Caregiver, Program Director, Teacher)  *
Email Address: *
Telephone Number *
Mailing Address  *
Which program are you interested in? Please Select From the Options Below: *
Required
Where are you located?  *
Please provide insight into who this program will support (the more details the better!)  *
Please provide details regarding the number of participants that would benefit from this program? (the more details the better!)  *
Please provide information on any barriers that your program participants encounter in their lives (select all that apply)  *
Required
When would you like the program to take place? (if possible please provide a date range and/or at least 3 different date options)  *
Has your organization ever had programs/services from The Harmony Kids Foundation in the past? (if yes, please specify time period and program details)  *
Please indicate what being chosen for your requested program would mean to members of your community. (What problems would it solve, or what benefits would learning these skills provide?)  *
Are you looking for in-person or online programming?  *
If in-person, where would the program be held? (if you do not have a space available, please specify this as well)  *
How did you hear about The Harmony Kids Foundation?  *
Required
Comments and/or Questions
Thank you for your program request. Applications will be processed within 30 days of receipt and successful applicants will be notified within 90 days of submission.  
Captionless Image
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms