Abundance Guidance Center
Please provide correct contact information as you will be contacted via email, text, and/pr by telephone with any questions we may have.
State ID or Dirvers Lic.
State ID #
Do you agree in accepting text messages?
Date of Birth
Do you have any health problems the instructor needs to know about? ex: Seizures, Diabetes, Low Blood Pressure ect.
How many children do you have? Name, Last, & Date of Birth. If you do not have children type: none
What classes are you enrolling for?
Co-Parenting High Conflict Focused (attending alone)
If referred by court, what kind of case do you have?
Department of Child and Family Services
I am volunteer
Why do you have an open case? What happened? Short explanation. If you are a volunteer please type NONE ABOVE
Please read your selection carefully. Parents attending alone for co-parenting please choose a day & time.
CHOOSE THE DATE AND TIME:
Monday's at 7:00pm Parenting/Co-Parenting...English Group
Thursday's at 8:00pm Parenting/Co-Parenting...English Group
Thursday's at 7:00pm Anger Management...English Group
NO REIMBURSEMENTS AFTER PAYMENT HAS BEEN COMPLETED
PLEASE MAKE SURE YOU CHOOSE YOUR OPTIONS AND READ YOUR MINUTE ORDER BEFORE ENROLLING.
Fees: Please choose carefully
Parenting or Anger Mgt Group Enrollment Only (Non-refundable) one parent ($15)
Parenting and Anger Mgt groups Enrollment Only (Non-refundable) ONE parent $20
Parenting or Anger Mgt First Class ($25) + Enrollment ($15) for one client
10 wks parenting total (with $50.00 off) + ENROLLMENT=one parent
12 wks anger mgt total (with $50 off + ENROLLMENT=one client
Enrollment for 2 parents attending parenting group
Please make sure you complete credit card/debit information using PayPal for secure processing. You do not need to have a PayPal account to complete payment.
Credit Card Type
Credit Card Number
Expiration Date (mm/yy)
I am aware that I am responsible for attending once a week and paying for any pending classes I will be taking when paying weekly. I am also aware that the information I typed is true. I will be completing additional forms when arriving to the center on my first day. Enrollment fee is non-refundable. Facilitator is a Mandated reporter who by law must report any physical, emotional, sexual abuse, and neglect towards any minor, disabled, and senior citizens.