Interest Form - Anxiety and Behavioral Health Center's Executive Functioning Skills Development Summer Program - For rising 6th through 9th graders who have challenges with executive functioning as demonstrated through difficulties with organization, planning, starting and completing tasks at home and at school, time management, AND initiating and maintaining friendships, AND effectively managing strong emotions.

Interest Form - Anxiety and Behavioral Health Center's Executive Functioning Skills Development Summer Program

For rising 6th through 9th graders who have challenges with executive functioning as demonstrated through difficulties with organization, planning, starting and completing tasks at home and at school, time management, AND initiating and maintaining friendships, AND effectively managing strong emotions.

In-Person

Session 1: August 11 - 14, 2025 from 9:30am - 12pm

Session 2: August 18 - 21, 2025 from 9:30am - 12pm

Parent Name

Parent E-mail Address

Parent Phone Number

What is the best way to contact you?

Phone E-mail Both/Either

Child's Name

Child's Age

Which session are you interested in?

Session 1

August 11 - 14, 2025 from 9:30am - 12pm

Session 2

August 18 - 21, 2025 from 9:30am - 12pm

What are you/your child's goals for participating in this program?

Are there any specific questions you have about this program?

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