Parents Apart Registration Form

Please fill out the following form to register for Parents Apart. Please note that you must make payment before your registration is accepted. REGISTRATIONS CANNOT BE MADE ON A CELL PHONE OR OTHER DEVICES, ONLY HERE ON THIS WEBSITE.


PLEASE KNOW THAT YOU AND YOUR SPOUSE CANNOT BE ENROLLED IN THE SAME CLASS AT THE SAME PLACE/TIMES.


If you are paying for a Court Waiver, a replacement certificate, or a missed class, please use the Online Shop for payment.

All starred (*) fields are required information.

EN: Internet Class Dates
Internet Class Dates
Aug 24 & 31
EN: *Name required true
*Name
EN: *Mailing Address for certificate required true
*Mailing Address for certificate


EN: *Phone required true
*Phone
EN: *Email required true
*Email
EN: *Full Name of other parent (not your name) required true
*Full Name of other parent (not your name)
EN: Do you have a Court Waiver?
Do you have a Court Waiver?
Yes
No
EN: Attorney or Mediator
Attorney or Mediator
EN: How did you learn of this program?
How did you learn of this program?
Website
My attorney or mediator
Friend
Email
Other