Request for Child Advocacy

Advocacy may be requested for:

Families with children up to age 21, who need special education services or accommodations through Boulder Valley or St. Vrain Valley School Districts (priority is given to families with a child with IDD).

Child's Name *
Child's Name
Does the child have a developmental disability?
Child's Date of Birth
Child's Date of Birth
Parent/Guardian's Name
Parent/Guardian's Name
Address
Address
Phone number
Phone number
Which school district is your child enrolled in?
Does your child currently have an IEP or 504?
Demographic Information: The ACL does not charge fees for services, so in order to keep our doors open, we apply for funding from various sources. These funders require us to report on the demographics (ethnicity, zip code, age, etc.) of the people we serve. Without this funding, the ACL would be unable to provide our current level of advocacy, support, and training. We understand that demographic information is sensitive, and we assure you no specific information is shared about you or any member of your family. All information is used for program planning and evaluation, and information reported to funders is separated from any identifying information, then totaled to show the impact of the work we do. This information will not affect any services you receive. Thank you for your assistance in our efforts to continue to provide advocacy, support, and education free of charge.
$
Child's Ethnicity