Pete & Jerry Rossman

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REACH - Online Program

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Student Birth Date *

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REACH

CLP

REC

ASAT/CHW

Please list the classes student is interested in *

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ASAT/CHW - Online Program

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REACH

CLP

REC

ASAT/CHW

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CLP - Online Program

Student First Name *

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REACH

CLP

REC

ASAT/CHW

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Stay Safe - Online Program

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Diagnosis:

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5.

6.

Parent Contact & Billing Information:

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First

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Last

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Other Emergency Contact:

Emergency Contact name *

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Special Needs or Considerations:

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REACH

CLP

REC

ASAT/CHW

Name of class student is applying for: *

Currently enrolled in high school or post-secondary program? If yes, please list school: *

Tell us how you heard about Chapel Haven:

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RecDesk - Online Program

Student First Name *

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REACH

CLP

REC

ASAT/CHW

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Parent First Name *

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Wellness - Online Program

Student First Name *

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CLP

REC

ASAT/CHW

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Helpful Info

Connect & Get Started

Chapel Haven Programs

Chapel Haven Schleifer Center

Chapel Haven West

Upcoming Events

Chapel Haven’s Golf Tournament is ON!

REACH and Continuing Ed Course Catalogue is out!

Sign up now for a Chapel Haven Schleifer Center virtual open house

Chapel Haven Schleifer Center

Chapel Haven West

Upcoming Events

Chapel Haven’s Golf Tournament is ON!

REACH and Continuing Ed Course Catalogue is out!

Sign up now for a Chapel Haven Schleifer Center virtual open house

Fill out this form to sign up for classes!

Fill out this form to sign up for classes!

Fill out this form to sign up for classes!

Fill out this form to sign up for classes!

Fill out this form to sign up!

Fill out this form to sign up!

Fill out this form to sign up!