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.

Internet Class Dates
October 1 & 8
*Name
*Mailing Address for certificate


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