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Program Inquiry
Programs Contact Form
If you are interested in applying to a program or would like more information, please fill out the form below and we will contact you.
Name
*
First
Last
Phone Number
*
Email Address
*
Age of Program Participant
*
Under 18
18 or Older
Program for Under 18
*
After School offered at Claremont, Long Beach and Pasadena
Summer
Aquatics
Camp Paivika
Program for 18 or Older
*
Adult Day
Aquatics
Camp Paivika
Community Integration (PossAbility Pasadena)
Community Integration (PossAbility Los Angeles)
College to Career
Employment Services
Group Residential Housing Crown House/Sierra Rose
Project SEARCH
Location
*
Claremont Center
Long Beach Center
Joan and Harry A. Mier Center
Supported Employment
Location
*
Claremont Center
Long Beach Center
Lawrence L Frank Center in Pasadena
East Los Angeles Center
Location
*
Joan and Harry A. Mier Center in Inglewood
Long Beach Center
Lawrence L. Frank Center in Pasadena
Location
*
Crown House
Sierra Rose
No Preference
Are You a Regional Center Client?
*
Yes
No
Comment - If Regional Center Client, Please Provide Service Coordinator Name/Email, Name of Child/Adult and Date of Birth
*
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