Step by Step PAT program application
Step by Step's PAT program is a parenting group for families of kids from pregnancy through age 5. We offer group connections, play dates, field trips, and other fun opportunities and activities for kids and their caretakers. Located on Charleston's West Side, our site offers two playrooms and a gym for a safe, fun indoor space for kids to play. We offer many participation incentives, and our parenting peers work with families to provide individualized support services as you find convenient for your needs. This unique parenting community is designed for parents, by parents. Join our village!
Sign in to Google to save your progress. Learn more
First and Last name *
Are you the parent or guardian of a child or multiple children under the age of 5? *
Are you or your partner currently pregnant?  *
What is the best contact information for us to reach you?  *
What is the second best contact information for us to reach you?
What is your zip code?  *
Is there anything you would like to add to this information to tell us more about yourself or your family to help us serve you better? 
Which of the following items in our program are you interested in knowing more about? Check all that apply.  *
The PAT program requires visits with your parenting partner at least once per month! These can be great opportunity to receive personalize services, including deliveries of food, diapers, hygiene supplies and more.  Are you willing to complete these visit every month? *
The PAT program is required to complete screenings with our clients to help customize our services and receive our financial funding. These include confidential questions about your child's development, your health and family well being. Your private information is never shared unless you tell us to.  Are you willing to complete these screenings?  *
How did you hear about our program? *
Clear form
Never submit passwords through Google Forms.
This form was created inside of Step by Step, Inc.. Report Abuse