Parallel Parenting Class!

Cooperative Parenting
Registration Form
(form revised 3/08)

To register for a Cooperative Parenting workshop, call 760-436-3039 and leave your name, your phone number and the workshop number you wish to attend. A confirmation letter will be sent to you right away.  Please complete this form & bring it to your first class.

Your name___________________________________________________________

Address_____________________________________________________________
                                    (street)                                                                                                            (city)                                         (zip code)
Your tel_________________________    ___________________________________
                                    (daytime)                                                               (evening)

e-mail__________________________________________________________

Other parent name_______________________________________________________

Other parent address _____________________________________________________
        (street)                              (city)                                         (zip code)

Other parent telephone____________________________________________________

Tuition Course Fee is $225 ($75 per session)

Reduced fee option:  If your household gross (pre-tax) annual income  is $20,000 or less, your tuition fee is $75 for the Cooperative Parenting Course ($25 a class).  You must be able to verify your income to qualify for the lower tuition fee.   Monthly income means the following:

1. Annual, gross (pre-tax) household income

2. Income received from all sources including new partner’s income and support payments you are receiving

If you qualify for the reduced tuition fee, please bring a copy of your pay stub, support check or W-2 form to verify household income.   

Guest Tuition:  Parents are encouraged to bring new partners to Cooperative Parenting.  A guest who wants to receive a graduation certificate pays 50% of that paid by their partner ($112.50 or $37.50).  Guests who do not wish to receive a graduation certificate pay nothing. 

Tuition can be paid weekly if this is helpful.   Visa, master card, personal checks and cash are acceptable forms of payment.   

 If you are using a check, please make it payable to “Shari Delisle”.