Parent to Parent (P2P) Support Parent Application

Ohio P2P is a statewide parent support program that matches parents, siblings, self-advocates, foster parents, grandparents, etc. who have family members of any age, with a disability or special healthcare need, to an experienced, trained, volunteer support parent.

Complete this form if you would like to volunteer to provide support to another parent, sibling, self-advocate, grandparent, etc.

If you would like to RECEIVE support, please complete this form "Request Support Here"

First Name

Last Name

Preferred Phone

HomeWorkMobile

Home Phone

Mobile

Work Phone

In which county do you reside?

What is your relationship to an individual with a disability and/or special healthcare need?

Type of Family Member

ParentGrandparentSiblingOther

Are you a

Family memberNon-family member

Other Relationship Explanation

Do you need an interpreter?

YesNo

How did you hear about Ohio Parent to Parent?

If Other Please Explain

Why are you interested in becoming a trained Support Parent for Ohio P2P?

Demographic Information

Why do we ask demographic questions (for example, your gender, race, ethnicity, etc.)?

We receive funding from the federal and/or state government to do our work. Collecting demographic information helps us show who we have reached and where we need to do better.

We do not require anyone to answer the questions and you can always respond with "I do not wish to disclose" If you have any concerns about our survey questions, please let us know.

I consider myself to be (check all that apply)

African American/BlackAsianCaucasian/WhiteBi/Multi racialI do not wish to disclose

I am

HispanicNon-HispanicI do not wish to disclose

Are you fluent in any languages besides English?

NoYes

I am fluent in

SpanishSomaliChinese (Mandarin)ASL (American Sign Language)Other

Other Language(s)

I am

MaleFemaleTransgenderNon-binaryOtherI do not wish to disclose

Please specify

Will you require any accommodations for the training?

YesNo

Accommodations required for the training

Contact Information