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General Inquiry

Name * Required
First Last
Phone * Required
Email * Required
County * Required
Which best describes the support you need: * Required
- Help registering for training
- Scheduling an on-site training
- Question about a training certificate
- Making a referral for mental health or behavior consultation
- Requesting coaching support
- Inquiring about the status of a coaching/consultation referral
- Other
Have you completed an online referral ? * Required
- Yes
- No
Have you completed a request for a quote ? * Required
- Yes
- No
Have you completed an online coaching request? * Required
- Yes
- No
To request an on-site training, please request an on-site training quote: Click here
To make a referral, please complete an online referral form: Click here
To request coaching support, please complete the request form: Click here
If you indicated "other" above, please provide details regarding your request. * Required
What is the title of the training you attended? * Required
What was the date of the training you attended? - must be mm/dd/yyyy format * Required
MM slash DD slash YYYY
What is your preferred method of support? * Required
- Email me the information I need.
- Either an email or a phone call would be helpful.
- I need to speak to someone on the phone.
What times of day work best for you? (check all that apply) * Required
- 9am-11am
- 11am-1pm
- 1pm-3pm
- 3pm-5pm
Please provide us with any additional information that will help us provide you with accurate and timely support.

Project ACT’s Funders Include

Dd Council

Baltimore Co

Msde

Mccrn

Maryland Family Network

8503 LaSalle Rd
Towson, MD 21286
Monday - Friday 9:00 am - 4:00 pm
443-900-6458 | crcbc@abilitiesnetwork.org

8503 LaSalle Rd
Towson, MD 21286
Monday - Friday 9:00 am - 4:00 pm
443-900-6458 | crcbc@abilitiesnetwork.org

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The Project ACT Child Resource Center of Baltimore, Harford and Cecil County is a member of the Maryland Child Care Resource Network with funding provided from the Maryland State Department of Education, through Maryland Family Network, and Abilities Network.