Group Interest Form

What IF your child could have a fun-filled group where strengths were seen first, goals were targeted strategically, and your family felt supported?

SUMMER 2017 GROUP ENROLLMENT

Complete the fields below and a Holland team member will contact you regarding group enrollment. Scholarship funding is available for families who qualify.

Child's Name *

First

Last

Child's Age *

I'm interested in *

Parent's Name *

First

Last

Phone Number *

Email *

Primary Concern *

Available Days & Times *

Additional Information *

Submit

GROUP Interest Form

SUMMER 2017 GROUP ENROLLMENT

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