Virtual Parent Book Club

Date Date / MM / DD YYYY
Participant Name: Participant Name: First Last
Participant Address Participant Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone - ### - ### ####
Email Address:
Are you a Paths for Families staff member, contractor, intern, or professional partner?

Are you a Paths for Families staff member, contractor, intern, or professional partner? No Yes
Type of Adoption
Where was your adoption finalized? (Please indicate city and state)
Have you ever participated in any Paths for Families programs (adoption, counseling, support groups, training, family finding, etc.)?
How did you hear about the Virtual Parent Book Club?:
Which book club meeting(s) would you like to join? Select all that apply.

Which book club meeting(s) would you like to join? Select all that apply. Raising Kids With Big, Baffling Behaviors | Thursday, October 9, 2025 | 7 PM - 8 PM 7 Core Issues in Adoption and Permanency | Thursday, October 23, 2025 | 7 PM - 8 PM
Do you need any accommodations to allow you to fully participate in this group? Please provide details in the space below.

Do you need any accommodations to allow you to fully participate in this group? Please provide details in the space below. No Yes
Select your free book! (Note: Only one selection will be sent to each household):

Select your free book! (Note: Only one selection will be sent to each household): "Raising Kids With Big, Baffling Behaviors' by Robyn Gobbel "7 Core Issues in Adoption and Permanency" by Sharon Roszia & Allison Davis Maxon Decline the free book
Please describe the racial/cultural makeup of your family. Your response helps the facilitators plan appropriate/relevant discussions.
Is there anything else you would like us to know?