Register for Youth Aid Panel Programs |

Please carefully complete the below form to register for the programs assigned to you by your Youth Aid Panel.

Youth's Name*

First

Last
Phone Number*

Best contact number in case class needs to be cancelled.
Email*

Please provide to receive your class confirmation.
Parent / Guardian's Name*

First

Last
Parent / Guardian's Email Address*
Parent / Guardian's Telephone Number*
Address*

Street Address

Address Line 2

City

State

ZIP Code
Panel Name (In which town was your Youth Aid Panel held?)*

If you do not know which panel you attended, please list where you panel meeting was held.
Panel Contact Name (The name of the person who gave you the resolutions)*

First

Last
Classes Assigned:*
- Problem Solving and Decision Making (Section 1)
- Teen Intervene (Section 2)
- My Path Ahead (Section 3)
- History in My Backyard (Section 4)
Scroll down to each section to register for the required class(es).
Section 1 – Problem Solving and Decision Making

Classes are held on the 4th Monday of each month.
Time: 6:30 pm – 8:00 pm
Location: Center for Resolutions, 26 E. 4th Street, Media, PA 19063
You will receive a confirmation by email within 2 business days.
Select date to attend Problem Solving and Decision Making
Section 2 – Teen Intervene

Please register for the dates provided by your panel. The classes will be held online from 6:30 pm to 8:30 pm.

You will receive a confirmation by email within 2 business days. This will contain the Zoom link and class instructions.
Select a date to attend Teen Intervene
Parent/Guardian Session
- Parent Session (Session 2, at 7:15pm)
Session 1 and 2 MUST be attended by the youth. Please indicate if a parent or guardian will be joining in the second session by checking the box above. If you do not mark the box, it will be understood that the guardian will NOT be attending.
Section 3 – My Path Ahead

Please register for the date provided by your panel. The class will be held the first Monday of every month online from 6:30 pm to 8:00 pm. You will receive a confirmation by email within 2 business days. This will contain the Zoom link and class instructions.
Confirmation of Completion: Holland Code Survey- https://openpsychometrics.org/tests/RIASEC/*
- Yes, I confirm I took the Holland Code Survey
Select date to attend My Path Ahead
Section 4 – History in My Backyard

Class and community service takes place 4th Saturday of every month from 9:30am – 11:00am
– 9:30-10:00am – Community Service
– 10:00am – 11:00am – Tour of site and one-on-one with a veteran
Class meets at Delaware County Veterans Memorial Park – 4599 West Chester Pike, Newtown Square, PA 19073

You will receive a confirmation by email within 2 business days.
Select date to attend History in My Backyard
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Register for Youth Aid Panel Programs

Section 1 – Problem Solving and Decision Making

Section 2 – Teen Intervene

Section 3 – My Path Ahead

Section 4 – History in My Backyard