Peer Pals

Sign Your Child Up to be a Peer Pal

Welcome to Peer Pals! The information you provide in the sign up form will be used to best match your child with a peer in your own community.

Whether you have a child with or without a disability, this is the place to share your information and become part of our growing community.

Some important notes ...

If you have more than one child, please fill out one form per child.
We ask for the name of the public school your child will/should attend for kindergarten, so that we may try to find a peer from the same school, not just the same district.
The information you provide will be used only to find and initiate a match with a local Peer Pal, and will not be shared with any other organization.
Once you submit your registration, you will be contacted shortly.

Email Address: *

First Name: *

Last Name: *

Address:

City:

State/Region/Province:

Zip: *

Phone:

Child's First Name: *

Chlid's Last Name: *

Child's Birthdate (mm/yy): *

Child's Gender:

Female
Male

Name of public school where your child will attend kindergarten:

My child has a disability:

No
Yes

Anything else you want us to know about you or your child:

* denotes required field