Developing Your Individualized Housing Action Plan - 10-week virtual program - Introductory Form

If you are interested in participating in this initiative, please take a moment to answer the questions below.

Completing this form and submitting the reservation fee of $250.00 will reserve a spot for you in the workshop.

The total cost for the workshop is $1,600.00 (includes HST). A invoice for $1350.00 will be sent out one week prior to the workshop beginning.

Please send reservation payments by e-transfer to admin@p4p.ca

PLEASE NOTE - We are only able to develop one plan per loved one in each workshop. If you required a plan for a second loved child you would need to register for a second spot in the workshop. Please contact Natalie Jones at njones@p4p.ca for more information.

In addition, the workshop is offered to one household. Should your loved one spend their time between two households we are asking that one parent attend the workshop if the parents are not currently living together in the same home.

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* 1. Please provide us with your contact information:

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. What is the name and age of your child/sibling/loved one with a disability?

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* 3. Please let us know if you would like to create a plan for more than one child.

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* 4. What is one word that describes your son/daughter or loved one? If so please give us some details.

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* 5. Why are you interested in participating in this project?

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* 6. Have you started to develop a housing plan or are you starting from scratch?

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* 7. Have you begun to develop a support network for your loved one?

Yes

I don't know what that is

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* 8. Are you already working with a facilitator? If so can you explain what you have worked on for your child with the facilitator?

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* 9. What is one outcome you would like to see as a result of your participation?

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* 10. Do you have any questions about the workshop? Please leave your questions here and a P4P staff member will follow-up with you.

Thank you for taking the time to complete our form.