Court-Mandated Parenting Seminar Registration Form
Sessions are taught by Dr. Jackson. Please fill out your details to register for the seminar. Once your form has been submitted and payment applied, you will receive a Welcome email within a few days. If you have questions or experience any issues, please email careformeyouth@gmail.com.
Which upcoming class session would you like to attend? (5pm- 9pm EST)
*
Wed. April 29
Wed. May 27
Wed. June 24
Your Name
*
First Name
Last Name
City of Residence?
*
Other Parent's Name
First Name
Last Name
What is your relationship to the child(ren) for whom you are enrolling in this class?
*
Mother
Father
Third Party with "legitimate interest" (e.g. grandparent, adult relative, or other adult)
Registrant Email Address
*
example@example.com
Registrant Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
How many children do you have?
Age of Children Involved?
*
Is there a pending court case? If yes, what is the city the court case will be heard in?
*
If the other parent in the case has registered with us to take this class, how do you feel about attending the same session?
*
I prefer not to be in the same session - please provide the co-parent's name above so that we can accommodate your request.
I have no concerns with being in the same session.
Is there a restraining order currently in place for either co-parent?
*
Yes
No
How did you hear about us?
Please provide information regarding your situation & what you hope to receive from this seminar?
Upload a picture of your State ID
*
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Court Mandated Parenting Seminar
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