Adult Anger Management Referral/Registration

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Tangipahoa Alcohol and Drug Abuse Council (TADAC) is offering Anger Management for adults 18+ at a reduced rate of $60/person due to funding from Northshore Community Foundation (NCF). Registration is due by the beginning of the first class date.

Participants are to attend all 6 sessions in order to receive certificate of completion.

May: 8, 10, 15, 16, 22, & 24

Name *

Include first and last name.

Gender *

Male

Female

Prefer not to say

Youth Ethnicity *

American Indian/Alaskan Native

Asian

Black or African American

Hispanic or Latino

Native Hawaiian/Other Pacific Islander

White

Other:

Required

Address *

City *

State *

Zip Code *

Phone Number *

Would you like to receive text alerts?

Yes

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Email *

Which month will you attend? *

October

November

December

Other:

Required

I understand that I am responsible to pay program fee of $60 upon arrival *

Yes

Required

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This form was created inside of TADAC. Report Abuse

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