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Group Registration
Please complete entire form. Call the office for further information at 936-760-1880 during business office hours -
Monday through Thursday
from 10am to 8pm
Please complete one form per person and one form per group.
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Group you are registering for?
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If you are registering for multiple groups, please complete a separate form for each group.
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Allied CoParenting - 12 hour EXTENDED class for Divorce
Understanding Parental Alienation Workshop
Productive Parenting Class
Anger Management
Substance & Alcohol Recovery
PRIVATE ($225) Parent Ed & Stabilization Course - 4 hour Court Approved Course for Families of Divorce
First & Last Name of group member (Nombre y Apellido del miembro del grupo):
*
Your answer
Date of Birth (Fecha de nacimiento)
*
Your answer
Cell phone# (Número celular):
*
Your answer
Email address (Dirección de correo electrónico)
*
Your answer
Address (Dirección):
*
House Number (Número de casa) / Street Name (Nombre de la calle) / City (Ciudad) / State (Estado) / Zip Code (Código postal)
Your answer
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