STRIVE Tweens Membership Form

OVERVIEW:
PSL Services/STRIVE is a non-profit organization that focuses on serving teens and young adults with developmental disabilities through socialization, education and employment training opportunities. Tweens is one of STRIVE’s newer programs created in direct response to a need for social activities for middle aged students. STRIVE Tween Socials are held at PSL Services/STRIVE center from 3:30 to 5:30pm every Friday. This program is specifically designed for 11 to 14 year olds and is modeled after the STRIVE Friday Night Socials.

CANCELLATION POLICY:
In the event of a Tween Social cancellation, a decision will be made by 1pm on that Friday and posted here on the PSL Services/STRIVE website: www.pslstrive.org, as well as run on the local television news tickers. If you have questions please feel free to call the office at 207-774-6278.

ELIGIBILITY CRITERIA

  • Be 11-14 years old to participate in the Tweens program.
  • Student must be able to provide personal care and/or provide support to assist.
  • Provide PSL Services/STRIVE with a completed application packet prior to participation in programs.
  • Demonstrate an interest in participating in STRIVE programs.
  • In order to keep PSL Services/STRIVE a safe place, PSL Services/STRIVE retains the right to decide if a member needs to be accompanied by a guardian or if appropriate staff is required.
FOR MORE INFORMATION OR QUESTIONS
Contact Olivia Fraioli, PSL Services/STRIVE Team Leader
ofraioli@pslstrive.org

 

Membership form

 

Contact Information

    Parent/Guardian

    Parent/Guardian

    Membership Information

    Please complete the following section as thoroughly as possible. This information enables us to plan a safe and successful experience for the member

    Please check any that apply and add any additional under “other”
    Please list the food, reaction, and treatment as applicable

    Behavioral Concerns:

    __________________________________________________

    Photo Release:

    Check if you agree to consent (leave unchecked if you disagree)

    __________________________________________________

    Transportation Alert:

    (Alerts us to people you DO NOT want to pick up the student) As a parent or legal guardian, I DO NOT authorize my students to be released/picked up by the following persons: