Parent Leadership Training Form

The Meriden Children First Initiative (CFI) helps children become ready, willing and able to succeed. CFI works with a variety of community partners to sponsor parent leadership trainings, publish useful research and information, and connect families with community resources.

Tell us about yourself:
(* denotes required fields)

First Name *

Last Name *

Address

Suite

City

State		Zip

Phone *

Fax

Website

Email *

I'm interested in:	PLTI Parents SEE

Will you require childcare?	Yes No
Number of children needing childcare:	Ages:

Will you require transportation?	Yes No

Race / Ethnic Background
White	Puerto Rican
Black/African American	Other Latino
Asian/Pacific Islander	Other:

What is a good time to discuss your interest in PLTI / ParentSEE?	A.M. P.M. (after 5:30)

What issues/concerns do you have regarding your children and your community?

What skills would you like to learn to become a stronger advocate for your children or community? Why?

How did you hear about PLTI/ParentSEE?
(Select all that apply.)

	Newspaper Ad/Story		Church Ad/Story
	Fair/Event Ad/Story		E-mail or Website
	Flyer from school School:		Picked Up Flyer From:
	Friend Name:		Other Source Name:

* * * REQUIRED:

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Parent Leadership Training Form