Coffee and Conversations *Middle & High School*
Join Coffee and Conversations on the first Monday of each month at 12pm if you have children in middle or high school.
Please provide your contact information.
Name (First and Last)
Email Address
Phone Number
What county do you live in?
Please select...
Allegany
Anne Arundel
Baltimore City
Baltimore County
Calvert
Caroline
Carroll
Cecil
Charles
Dorchester
Frederick
Garrett
Harford
Howard
Kent
Montgomery
Prince George's
Queen Anne's
St. Mary's
Somerset
Talbot
Washington
Wicomico
Worcester
What is your race?
Please select...
American Indian or Alaska Native
Asian or Asian American
Black or African American
Native Hawaiian or other Pacific Islander
White or Caucasian
Multiple Races
What is your ethnicity?
Please select...
Hispanic or Latino
Non-Hispanic or Latino
Please provide your child's date of birth.
What is your child's gender?
Female
Male
What is your child's race?
Please select...
American Indian or Alaska Native
Asian or Asian American
Black or African American
Native Hawaiian or other Pacific Islander
White or Caucasian
Multiple Races
What is your child's ethnicity?
Please select...
Hispanic or Latino
Non-Hispanic or Latino
What is your child's diagnosis? (Please check all that apply.)
Autism
ADD/ADHD
Deaf/Blind
Deaf/Hearing Impairment
Developmental Delay
Intellectual Disability
Emotional Disability
Learning Disability
Multiple Disabilities
Other Health Impairment
Orthopedic Impairment
Speech and Language
Traumatic Brain Injury
Vision Impairment/Blind
Suspected Disability
None
Other
If you selected 'Other', please specify your child's diagnosis.
Be on the lookout for emails from communications@ppmd.org with Zoom links to join our Coffee and Conversations virtual parent group. If you have any questions, please reach out to communications@ppmd.org
Contact Information