Children & Youth Interest Form | EECM

top of page

Home
Night of Inspiration
Get Help
How to Help
Donate
What We Do
Who We Are
More

Use tab to navigate through the menu items.

Interest Sheet

Parent/Guardian Name

Address

Parent/Guardian Cell Phone

Child's Name

Parent/Guardian Email

Child's Age

School Child Attends

Which program(s) ar you interested in: * Required

Creation Station

L5 (Fulton School Only)

Project Rediscovery (In-School Program Only)

Girl's Life (In-School Program Only)

Hockey

Recreation

Take Your Son/Daughter to Work

Hoop-It-Up

Day Camp

Leave us a message...

Thanks for submitting!

6140 STATION STREET

PITTSBURGH, PA 15206

East End Cooperative Ministry is a 501(c)3 nonprofit and an Equal Opportunity Employer. EIN: 23-1722988

bottom of page