Chicago Parenting Program: Family Registration Questionnaire

Welcome!

Thank you for your interest in the Chicago Parenting Program (CPP)!

The Chicago Parenting Program is a national, evidence-based 12-week parenting program designed to support parents and caregivers of young children ages 2–8. The program provides families with practical parenting strategies to strengthen relationships, build parenting confidence, support children’s social-emotional development, and promote children’s mental health and well-being.

Our goal is to create a welcoming space where parents and caregivers can connect with one another, learn new strategies, and feel supported in their parenting journey. The program is held on Friday mornings from 10am-12pm, but you are welcome to arrive as early as 9:30am for a complimentary breakfast.

Please complete the following questionnaire to help us learn more about your family and determine how we can best support you.

Parent/Caregiver Name:

First NameLast Name

Child/Children's Name

Child/Children’s Age(s):

What school does your child/children attend?

Are you able to commit to attending at least 8 of the 12 sessions?

TIME Organization offers a variety of programs and resources designed to support children, families, and individuals in reaching their goals and building stronger, healthier communities.

What time of the day would you be available for parent workshops and activities?

Would you like to learn more about other opportunities available through TIME Organization?

If yes, may TIME Organization contact you by email regarding these opportunities?

If yes, please provide your email address below:

example@example.com

Thank you for allowing us to support your family!

What is the best way to contact you regarding the Chicago Parenting Program? (Please select all that apply)

Mobile Phone

Format: (000) 000-0000.

Email Address

example@example.com

If you selected phone, what is the best time of day to contact you?

Would you like to receive information about other programs and services available through TIME Organization?

If yes, may TIME Organization contact you by email regarding these opportunities?

Thank You!

Thank you for expressing your interest in the Chicago Parenting Program!

Your information will help us prepare for your participation and connect you with program updates and registration information.

The first session begins Friday, October 2.

Please be on the lookout for important information between now and the start of the program. A member of our team will contact you by phone and/or email to confirm your registration and provide additional details.

We look forward to meeting you and supporting your family!

Chicago Parenting Program

PART 1: Family Information & Program Interest

Family Information

Program Commitment

If You Are Unable to Commit to the Program

PART 2: Registration & Family Connection

Staying Connected

Connecting You With Additional Support