“Using the power of conflict to build strong, stable and peaceful communities”

School Referral Form

  • Student One:

  • Date Format: MM slash DD slash YYYY
  • Student Two:

  • Date Format: MM slash DD slash YYYY
  • PLEASE NOTE: A school staff person familiar with this incident must be available to CCP should further information be needed. Please provide their name and phone number below:

You will receive an email confirmation within 24 hours stating that we have received your referral! If you do not receive such, call or email CCP ASAP. This means we did not receive your referral. Thank you! We are happy to help.