Project Connect
Please fill out the form below if you are interested in information.
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Parent/Guardian Name *
Address *
Telephone *
Email *
Please List the names of the students you are interested in referring for services. (This could be self referral by the parent or a referral from the school/community.) Please format: Child's Name; Date of Birth; School
There is no word limit to this response.
Person making the referral
Someone from Project Connect will contact you to discuss registration options. If you have questions, please call (513) 363-6570.  
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