Kids In The Middle® Parents Advisory Council
(KIMPAC)

Kids In The Middle® invites parents of past and current clients to join KIMPAC, a special advisory council designed to provide feedback about the programs and services we offer and to improve our efforts to promote and support the organization!

As a KIMPAC Member you can advise us about...

Ways we can be more responsive to our client families
Ways we can be more responsive to the community
Ways we can improve our services

And, if you want to, you can also become...

Ambassadors for Kids In The Middle®
Volunteers for Kids In The Middle®
Fundraisers for Kids In The Middle®

Please fill out the brief informational form below if you would like to become a member of KIMPAC©. Feel free to contact our Executive Director, Judy Berkowitz with any questions.

Contact Information

Title:
First:
Last:
Telephone:
E-Mail:

Please select if you are a...

	Current KITM Parent
	Former KITM Parent
	Neither

How many children are currently, or were previously, enrolled in KITM Services?

Which KITM services do/did your children participate in?
(check all that apply)

	Group therapy sessions at the Kirkwood facility.
	Individual therapy sessions at the Kirkwood facility.
	Group therapy in his/her school.
	The Children Together After Separation (CTAS) program through the St. Louis City court system.

Which KITM services do/did you, as a parent, participate in?
(check all that apply)

	Group therapy sessions for parents at the Kirkwood facility.
	Individual therapy sessions for parents at the Kirkwood facility.
	Cordial Parent Relationship (CPR) training at the Kirkwood facility.
	Focus On Children After Separation (FOCAS) training at the Kirkwood facility.
	Mediation services.
	Parents Together After Separation (PTAS) program through the St. Louis City court system.

If you have any general questions or comments about KITMPAC, please use the area below:

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Kids In The Middle® helps children, parents and families thrive during and after divorce through counseling, education and support.

Kids In The Middle® Parents Advisory Council(KIMPAC)