Self-Care and Finding Your Circle of Support (Dorchester County In-Person Training)
Please register if you will join us on June 18, 2025 11-11:45am at the Dorchester Public Library
Meeting Room,
303 Gay St.
Cambridge, MD 21613
. Refreshments will be provided. We are excited to see you there! Please email communications@ppmd.org with any questions.
First Name
Last Name
Email Address
Phone Number
Please describe yourself
Parent/Guardian
Other relative
Student/Youth
Professional
Organization/Company
County of Residence
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? (
This question helps PPMD to ensure we are reaching everyone in our community and to receive grants to fund our programming)
American Indian or Alaska Native
Asian or Asian American
Black or African American
Native Hawaiian or other Pacific Islander
White or Caucasian
Two or more races
Other
Prefer not to answer
What is your ethnicity? (
This question helps PPMD to ensure we are reaching everyone in our community and to receive grants to fund our programming)
Hispanic or Latino
Non-Hispanic or Latino
Prefer not to answer
Select the age(s) of your child(ren)
0-3 years old
4-5 years old
6-11 years old
12-14 years old
15-18 years old
18-21 years old
22+ years old
Select the gender(s) of your child(ren)
Female
Male
Nonbinary
Prefer not to answer
What is your child(ren)'s race? (
This question helps PPMD to ensure we are reaching everyone in our community and to receive grants to fund our programming)
American Indian or Alaska Native
Asian or Asian American
Black or African American
Native Hawaiian or other Pacific Islander
White or Caucasian
Two or more races
Other
Prefer not to answer
What is your child(ren)'s ethnicity? (
This question helps PPMD to ensure we are reaching everyone in our community and to receive grants to fund our programming)
Hispanic or Latino
Non-Hispanic or Latino
Prefer not to answer
Please select any disabilities your child(ren) has
Autism
ADD/ADHD
Deaf/Blind
Developmental Delay
Intellectual Disability
Deaf/Hearing Impairment
Emotional Disability
Learning Disability
Multiple Disabilities
Other Health Impairment
Orthopedic Impairment
Speech and Language
Traumatic Brain Injury
Vision Impairment/Blind
Suspected Disability
None
Other
Please select if your child has an IEP or 504 plan
Individualized Education Program (IEP)
504 plan
None
Do you need any accommodations to attend this training? (i.e. interpretation, large print, etc.)
Contact Information