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CLICKS 2.0 Parent/Guardian Information and Consent Form

General Information - This form must be submitted before your child can participate in the CLICKS Mentoring Program (an asterisk indicates a required field).
Region *This question is required.
Contact Information
Correspondence will be sent to this email address, so please check it regularly. This question requires a valid email address.
Demographic Information
Preferred Pronouns
Racial Identification *This question is required.
Preferred Language *This question is required.
Marital Status
Are you bilingual? *This question is required.
Are you or anyone in your family currently an active military service member or veteran? *This question is required.
Has your household been affected by incarceration? *This question is required.
Is your child eligible for free or reduced lunch? *This question is required.
Has your household been affected by substance abuse? *This question is required.