Skip to form

image

Parent and Adolescent Support Services (PASS) Program

PASS is an early intervention voluntary program that works with youth ages 10-17 committing status offenses (skipping school, running away from home, violating curfew, and/or being extremely disobedient), and low-level delinquency offenses when accompanied by a status offense. Referrals to the program are open to the public. 

Youth's Full Name

Youth's Date of Birth

Date Picker

Parent/Guardian Name

Parent/Guardian's Address

    Referred by

    Name of Person making Referral

    Referral date

    Date Picker

    Reason for Referral

    Attach Document

    Click Here to Upload

    Check if youth is currently receiving the following services:

    NOTE: If a referral is submitted by a school, please attach the youth’s most recent attendance report, transcript, IEP or 504 Plan, if applicable.

    Youth Services Division, 64 New York Ave., NE, 5th FloorPhone: (202) 698-4334 (phone), Fax: (202) 478-5747