Connect with AFC (Parents & Guardians)

Step 1 of 4

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Company

This field is for validation purposes and should be left unchanged.

Step 1

Please use this form to connect to all of Action for Children programs! Looking for FatherUp? You’re in the right place! Select the Parenting Supports & Services option in Step 2 to get connected to the FatherUp team.

General Information:

First Name*

Last Name*

Phone Number*

Email*

County*

Action for Children is located in central Ohio and serves Delaware, Fairfield, Franklin, Licking, Madison, Pickaway, and Union counties. Select programs are also available in Knox, Marion, and Morrow counties.

Zip Code*

Preferred Method of Contact*

Best Time to Reach You*

Do you need a translator?*

Yes

What language do you speak?

What service would you like to be connected with first? (Pick only one)*

(FatherUp) Are you a father looking for support groups, case management, and employment support through FatherUp?

(Parenting Services) Are you going through a divorce, separation or do you have a court order?

(Triple P) Are you looking for support in behavioral management strategies?

(Mothers Matter) Are you a mother looking for support groups, case management, and employment support?

(Child Care Information and Referrals) I'm looking for a child care provider or have questions about quality early childhood education experiences.

(Franklin County RISE) I'm looking for information about child care scholarships.

(SPARK) I'm interested in kindergarten readiness through home visiting.

(Help Me Grow) I'm pregnant or have a new baby and I’m interested in supports that promote healthy growth and development during pregnancy and throughout my baby’s early years.

(Help Me Grow) I have a child under 3 years old and am looking for support with disabilities and/or developmental delays.

(Children Services Hub) I'm looking for foster, adoption, or kinship support.

(Parent and Youth Ambassadors) I'm looking for local community resource navigation and support or a service not listed here.

Since you selected "I'm interested in parenting supports and services":*

(FatherUp) Are you a father looking for support groups, case management, and employment support through FatherUp?

(Parenting Services) Are you going through a divorce, separation or do you have a court order?

(Triple P) Are you looking for support in behavioral management strategies?

(Mothers Matter) Are you a mother looking for support groups, case management, and employment support?

What other services are you interested in learning more about? (Select all that apply)

(FatherUp) Are you a father looking for support groups, case management, and employment support through FatherUp?

(Parenting Services) Are you going through a divorce, separation or do you have a court order?

(Triple P) Are you looking for support in behavioral management strategies?

(Mothers Matter) Are you a mother looking for support groups, case management, and employment support?

(Child Care Information and Referrals) I'm looking for a child care provider or have questions about quality early childhood education experiences.

(Franklin County RISE) I'm looking for information about child care scholarships.

(SPARK) I'm interested in kindergarten readiness through home visiting.

(Help Me Grow) I'm pregnant or have a new baby and I'm interested in supports that promote healthy growth and development during pregnancy and throughout my baby's early years.

(Help Me Grow) I have a child under 3 years old and am looking for support with disabilities and/or developmental delays.

(Children Services Hub) I'm looking for foster, adoption, or kinship support.

(Parent and Youth Ambassadors) I'm looking for local community resource navigation and support or a service not listed here.

Since you selected "I'm interested in parenting supports and services":*

Are you a father looking for support groups, case management, and employment support through FatherUp?

Are you going through a divorce, separation or do you have a court order?

Are you looking for support in behavioral management strategies?

Are you a mother looking for support groups, case management, and employment support?

Do you need help with something else?*

Parent and Youth Ambassadors (PYAs) provide support for families through service referrals and assistance with benefit navigation.

Yes

Tell us a little bit about what you need that is not listed in our services!*

Consent

I would like to receive email resources and information from Action for Children related to parenting.

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