Advocacy Bootcamp Application
The Northeast Region of Massachusetts Families Organizing for Change, with generous support from the Cooperative for Human Services, is delighted to invite families from across the state to participate in Advocacy Bootcamp.

Advocacy Bootcamp is a free training that focuses on building foundational advocacy skills so we can empower our children to lead rich, meaningful, and exciting lives. We welcome applications from primary caregivers of young children (birth to age 10) who have developmental disabilities, chronic illnesses, and/or complex medical needs.

We will be convening at the Cooperative for Human Services at 420 Bedford Street, Suite 100, in Lexington, Massachusetts. This four-session program will run from 9:30 a.m. to 3:30 p.m. on the following Saturdays:
September 8th
September 22nd
September 29th
October 13th

Applications must be completed by August 1st, 2018.

TO ACCESS THIS FORM IN SPANISH https://goo.gl/forms/febwTwvMGdBFKilp2

Questions? Please reach out to Amanda Bailey, Central Middlesex Outreach Coordinator, at ambailey81@gmail.com

Name *
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Email address *
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Telephone/cell phone
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Address
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City *
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Zip code
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Are you the primary caregiver to a child with a disability or chronic illness? *
Each session of Advocacy Bootcamp runs from 9:30 a.m. until 3:30 p.m. on Saturdays. *
Please select each date below to confirm your commitment to attending all sessions.
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Please include a description of your child and his or her age. If you are caring for more than one child with a disability or chronic illness, please include information about all of your children.
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What services and activities is your family currently receiving and participating in?
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What prompted you to apply for Advocacy Bootcamp? *
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How do you hope to utilize the skills you'll gain through Advocacy Bootcamp?
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We have a limited amount of respite funding available on an as-needed basis. Will you require any type of respite to attend and participate?
Is there anything else that you would like to share about yourself and/or your family that would assist us in reviewing your application?
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Will you require any type of language support, including interpretation or translation? If so, in what language?
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