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Parent Information Program Registration

  1. For items that are not applicable, enter 'N/A'

  2. Is an Order or Protection Currently in Effect?*
  3. Do You Have a Fee Waiver or Deferral from the Court?
  4. Do You Require the Assistance of an Interpreter?*
  5. Would You Like to Receive Class Material in Spanish?*
  6. Are you Requesting to Complete the Class Via DVD or Online?
  7. Would You like to Receive an Automated Reminder of This Class by Phone?*

    Reminder calls are done the Wednesday prior to the class.

  8. Leave This Blank:

  9. This field is not part of the form submission.