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Professional Provider Supervised Visitation Monitor Training Registration
3878 Old Town Ave #200, San Diego CA 92110
Contact us for more information at (619) 683-9340 ext 33013 or
training@sandiegopops.org
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* Indicates required question
Name
*
Your answer
Phone Number
*
Your answer
Email Address
*
Your answer
Are you 21 years of age or older?
*
Yes
No
Do you have a current or have you had a past court order in which you have been/are the person being supervised?
*
Yes
No
Have you had a record of a conviction for child molestation, child abuse, or other crimes against a person?
*
Yes
No
Have you had any civil, criminal, or juvenile restraining orders within the last 10 years?
*
Yes
No
Have you have been on probation or parole during the past 10 years?
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Yes
No
Do you have a record or conviction of driving under the influence (DUI) within the last 5 years?
*
Yes
No
Do you have proof of automobile insurance (for transporting child/ren)?
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Yes
No
I understand that I will have to pay $250 before or upon arrival of first day of training.
*
Yes
Required
How will you pay your registration fee?
*
Cash
check (payable to Paternal Opportunities Programs and Services)
Do you have Trustline/Live Scan?
*
Yes
No
In progress
Are you a community partner?
*
Yes
No
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