Open Arms Perinatal Services -- Black Parents PEPS Group Registration

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Open Arms Perinatal Services -- Black Parents PEPS Group Registration - March 2023

We're excited to start this eight week journey with you, and we would love to learn more about you, your children and creating this space together.

Email *

Name *

We will connect together on WhatsApp and on Zoom weekly.

What is your preferred phone number? Please make sure we can add this # to our WhatsApp group. *

Please share your zip code

How old are you? *

17 or younger

18-30

30-45

45+

Prefer not to answer

What do you hope to get from participation in this PEPS group? *

Build Community with other Black Parents

Learn about Pregnancy

Learn about Parenting

Learn about Child Development

Networking

Finding and Sharing Resources

Build a local Play Group

Other:

Required

Tell us about your children, their names, ages, and any other information you would like to share! *

Please take the time to share your feedback on our short survey: PEPS Survey Thank you!

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms