Event and Workshop Registration Form
PERSONAL INFORMATION
* First Name:
* Last Name:
Company Name:
Title:
* Email Address:
* Address:
* City:
* State:
* Zip:
* Daytime Phone:
Evening Phone:
Fax:
Other Phone:
* How may we contact you?
Phone
Postcard
Email
Fax
* All calls placed from our office show as private on caller ID. Due to confidentiality laws, when we contact you (via phone, email, postcard, fax, etc.) regarding your registration, may we identify ourselves as a representative from CARE?
Yes
No
Yes, I would like to receive CARE's FREE newsletter, Stepping Stones.
How did you hear about us?
Attorney
At work
Church
Court
Employer
Flyer
Friend
Library
Newspaper
Not specified
Prior participant
Professional referral
Radio
School
Television
Website
Comments:
Be sure to check the checkbox in the top left of every event and workshop you want to attend.
REGISTER FOR EVENTS
REGISTER FOR WORKSHOPS
More Info
Nurturing Parenting Program for Non-custodial Parents.
on Tuesday, January 13, 2009
Non-Contracted:
$30.00
Tickets:
1
2
Parenting Partner:
C / + $15.00 Non
More Info
Adolescent Anger Management 9-11years
on Thursday, January 15, 2009
Contracted:
$120.00
Non-Contracted:
$140.00
Tickets:
1
2
Parenting Partner:
More Info
Adolescent Anger Management 12-14 years
on Thursday, January 15, 2009
Contracted:
$120.00
Non-Contracted:
$140.00
Tickets:
1
2
Parenting Partner:
More Info
Nurturing Parenting Program for Non-custodial Parents
on Friday, January 16, 2009
Non-Contracted:
$30.00
Tickets:
1
2
Parenting Partner:
C / + $15.00 Non
More Info
Parenting Young Children
on Monday, January 26, 2009
Tickets:
1
2
Parenting Partner:
More Info
Parenting Teenagers
on Monday, January 26, 2009
Non-Contracted:
$30.00
Tickets:
1
2
Parenting Partner:
C / + $15.00 Non
More Info
Parenting School Aged Children
on Monday, January 26, 2009
Non-Contracted:
$30.00
Tickets:
1
2
Parenting Partner:
C / + $15.00 Non
More Info
Parenting Young Children
on Tuesday, January 27, 2009
Tickets:
1
2
Parenting Partner:
More Info
Parenting Teenagers
on Tuesday, January 27, 2009
Non-Contracted:
$30.00
Tickets:
1
2
Parenting Partner:
C / + $15.00 Non
More Info
Parenting Teenagers
on Tuesday, January 27, 2009
Non-Contracted:
$30.00
Tickets:
1
2
Parenting Partner:
C / + $15.00 Non
More Info
Teaching and Leading Children (TLC)
on Tuesday, January 27, 2009
Non-Contracted:
$28.00
Tickets:
1
2
Parenting Partner:
More Info
Parenting Young Children
on Wednesday, January 28, 2009
Tickets:
1
2
Parenting Partner:
More Info
Parenting School Aged Children
on Wednesday, January 28, 2009
Non-Contracted:
$30.00
Tickets:
1
2
Parenting Partner:
C / + $15.00 Non
More Info
Parenting Teenagers
on Wednesday, January 28, 2009
Non-Contracted:
$30.00
Tickets:
1
2
Parenting Partner:
C / + $15.00 Non
More Info
Parenting School Aged Children
on Wednesday, January 28, 2009
Non-Contracted:
$30.00
Tickets:
1
2
Parenting Partner:
C / + $15.00 Non
More Info
Parenting Young Children
on Thursday, January 29, 2009
Tickets:
1
2
Parenting Partner:
More Info
Parenting School Aged Children
on Thursday, January 29, 2009
Non-Contracted:
$30.00
Tickets:
1
2
Parenting Partner:
C / + $15.00 Non
More Info
Parenting Young Children
on Monday, February 2, 2009
Tickets:
1
2
Parenting Partner:
More Info
Teen Intervene
on Wednesday, February 4, 2009
Contracted:
$120.00
Non-Contracted:
$140.00
Tickets:
1
2
Parenting Partner:
More Info
Parenting School Aged Children
on Wednesday, February 4, 2009
Non-Contracted:
$30.00
Tickets:
1
2
Parenting Partner:
C / + $15.00 Non
More Info
Parenting Teenagers
on Thursday, February 5, 2009
Non-Contracted:
$30.00
Tickets:
1
2
Parenting Partner:
C / + $15.00 Non
More Info
Adolescent Anger Management 15-18 years
on Thursday, February 26, 2009
Contracted:
$120.00
Non-Contracted:
$140.00
Tickets:
1
2
Parenting Partner:
