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Pierce County Parent to Parent Program

For additional information, please call Michele Lehosky or Betty Johnston, Parent to Parent Coordinators at 253-565-2266 (v/tty) 1-800-572-7368 (v/tty) or fill out this FORM and we will mail you information.

Each field with an * is a required field. Please, fill them out completely.

*First name:
*Last name:
*Street:
*City:
*State:
*Zip code:
Email:
*Area code:
*Telephone #:

(We appreciate having your phone number, in case we have questions)

	I would like to talk with a Helping Parent
	I would like parent information packet
	I would like information on a disability
	I would like information on the Community Inclusion Program.
	I would like to become a Helping Parent Volunteer
	Other

Washington PAVE | 6316 So. 12th St. | Tacoma, WA 98465
(253) 565-2266 (v/tty) | 1-800-5-PARENT (v/tty) | Fax: (253) 566-8052
E-mail:wapave9@washingtonpave.com

Washington PAVE has a policy of nondiscrimination. In the event you, as an employee or recipient of services, feel that you have been discriminated against on the basis of race, color, national origin, marital status, disabled or Vietnam era veteran status, sex, disability, religion, creed, age, sexual orientation, or HIV/AIDS status, you have the right to file a complaint with the agency´s 504 Compliance Officer.

Please contact PAVE´s Compliance Officer: Heather M. Hebdon,6316 South 12th. Street; Tacoma, WA 98465-1900, Phone:(253) 565-2266 (v/tty); 1-800-5-PARENT (v/tty); Fax: (253) 566-8052, E-mail:hhebdon@washingtonpave.com