2024GaPMP Kickoff Registration Form

2024 Kickoff Registration Form

Trailblazing to Success: Embracing New Paths on the Journey
District Name
Your Role

Parent MentorDirector or DesigneeGaDOE StaffAgency Partner
Agency Name, If Applicable
Name

First NameLast Name
Email
example@example.com
Do you have accessibility needs?

YesNo
If yes, what are those needs?
Are you a presenter

YesNo
For parent mentors and directors/designees only:

Select the area below that reflects the work the parent mentor plans to focus on with their target families.

(This does not represent everything the parent mentor will do but this data collection will be reflected in their required reporting.)
NEW MENTORS: Building Partnerships and CommunicationAttendance, Behavior, Course Completion (ABCs) and/or LiteracySelf-determination and/or IEP ParticipationTransition, Postschool Outcomes and/or Graduation
Should be Empty:

2024 Kickoff Registration Form