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*Online Parenting Class
Registration Form*
--THIS CLASS IS ACCEPTED BY COURTS IN THE US & CANADA--
Full Name - As you would like it to appear on your Certificate
*
Case #: (If you don't have one, write "None")
You may have a Court case or case with Child Protective Services or DCSF. If you would like your case number to be printed on your certificate, please list it here. If not, just type "None" or N/A.
Mobile Phone number
*
Email address for Certificate to be sent to
*
Street address
*
City
*
State
*
Please Select
Alabama - AL
AK - Alaska
AZ - Arizona
AR - Arkansas
CA - California
CO - Colorado
CT - Connecticut
DE - Delaware
FL - Florida
GA - Georgia
HI - Hawaii
ID - Idaho
IL - Illinois
IN - Indiana
IA - Iowa
KS - Kansas
KY - Kentucky
LA - Louisiana
ME - Maine
MD - Maryland
MA - Massachusetts
MI - Michigan
MN - Minnesota
MS - Mississippi
MO - Missouri
MT - Montana
NE - Nebraska
NV - Nevada
NH - New Hampshire
NJ - New Jersey
NM - New Mexico
NY - New York
NC - North Carolina
ND - North Dakota
OH - Ohio
OK - Oklahoma
OR - Oregon
PA - Pennsylvania
RI - Rhode Island
SC - South Carolina
SD - South Dakota
TN - Tennessee
TX - Texas
UT - Utah
VT - Vermont
VA - Virginia
WA - Washington
WV - West Virginia
WI - Wisconsin
WY - Wyoming
ZIP code
*
How did you find this class?
Google
Court Provider List
Referral From Attorney
Referral from a previous student
Other
Which class do you need?
Parenting (Standard, Court-Approved class)
Co-Parenting - STOP, go back and choose Co-Parenting at registration!
When do you need the class completed by?
Year
/
Month
/
Day
List your children's names AND ages:
Other Parents Full Name
How much of the time are you comfortable with the way you parent?
Most of the time
Some of the time
Rarely
How much of the time do you feel present and involved in your child's life?
Most of the time
Sometimes
Rarely
Have you ever taken a Parenting class before?
Yes
No
Not sure
If you have a Court order, are there any topics it specifies covering?
Message
After clicking 'Submit' below, you will be directed to our secure payment portal to take care of your tuition ($59), then you will receive an email with the link to begin your class. Thank you!
If you have any questions please call during regular business hours.
(760) 715- 0550
Submit