2025 Baby LEADers Application

Please complete this application by January 24, 2025 if you are interested in joining our Baby LEADers class this Spring. Families who are selected will join a virtual orientation session on February 10, 2025 and the virtual classes on March 1, 8, 22, 29 and April 5, 2025.

Please reach out to communications@ppmd.org with any questions.

Please provide us with your contact information.

First Name

Last Name

Address Line 1

Address Line 2

City

State

Zip Code

Email Address (we will be communicating with you through email!)

Phone Number

Which county do you live in?

What is your ethnicity?

Hispanic or LatinxNon-Hispanic or LatinxPrefer not to answer

Please check if your child attends any one of the following locations.

Does your child have an IFSP, IEP, or 504?

IFSPIEP504None

Please tell us briefly what you hope to gain from the training.

How will you use the information learned in this training?

I commit to attending all training dates.

Yes

I understand that I am expected to volunteer a minimum of 12 hours using the skills learned during this training to support other families. We ask that you complete this within 12 months.

Yes

Do you need a sign language interpreter?

YesNo

By applying to this training, I grant permission to The Parents' Place of Maryland (PPMD) to use photographs of myself and/or family members in attendance for any lawful purpose, including publicity, advertising, and web content. I also acknowledge that I am over the age of 18.

YesNo

ACCOMMODATIONS: Tell us about any accommodations you need (i.e large print)

Contact Information