PASS Cape Cod

Positive Alternative to School Suspension

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Intake Form

PASS is currently accepting students from the following high schools: Barnstable, D-Y, Falmouth, Harwich Cape Tech and Sturgis East & West. 

Schools must complete and submit this PASS Intake Form hosted by Google.

Referral Process

  • Schools should email the PASS Program Director at ccpassprogramdirector@gmail.com BEFORE submitting a referral to ensure that there is space for the student. Space is limited, the program can host 6-8 students at a time.
  • Once space is confirmed, we encourage the team of school point person, parent/guardian and student to sit together (in person or over the phone) to complete the intake form as information from all parties is required. This will help avoid incomplete or inaccurate forms.
  • The intake form should be submitted at least 24 hours prior to the student’s start date. Once the intake is received and reviewed, a Welcome Email will be sent to the student, parent/guardian and school to confirm enrollment.