Sponsored by the Catawba County Parenting Network

We want to make it as simple as possible for you to register for our parenting classes.
Now you can register online!
Simply fill out the form below, then press "Submit". It's as simple as that.
 
Please provide the following contact information
All information is kept in strict confidence. 
NOTE: A parent inventory is required for some classes.

* 
 
Which class are you registering for?
Note: You must specify a class
Simply click on your choice in the box below.
 If you would like to register for more than one class, please make note of additional class requests in the Comments box at the bottom of this form.
 
   
   
  Date of Class:
   
Who
 		  referred you to Catawba Parenting Network?
Referral information is required for registration.
 
   

Name:   

  Address:   
City:   
  State:   
  Zip:   
 Email      Address:  
Phone    Number:  

 Additional  Phone # :   		Work? Cell? Please specify in box beside number.
(Ex.:  Cell  233-9999)
Fax:
May we leave a message?  
   
Highest grade completed
Note:    DOB required for registration
Date of Birth:   xx/xx/xxxx
Sex:   (M) Male or (F) Female
Race:  Please select one from the drop down
   
Income:  Please select one from the drop down
 
   
What  is your primary language:
 
   
What  other languages do you speak?
 
What is the name of your spouse or significant other:
 
What is your current parenting status or relationship
to the child/children?
 
How many children live in the household?
 
Please identify your children:
 
First Name:
Last Name:
Middle Initial:
Date of Birth:
Sex:
Your            Relationship:
Does  he/she have special needs
Daycare/School he/she attends:
   
   
First Name:
Last Name:
Middle Initial:
Date of Birth:
Sex:
Your            Relationship:
Does  he/she have special needs
Daycare/School he/she attends:
   
   
First Name:
Last Name:
Middle Initial:
Date of Birth:
Sex:
Your            Relationship:
Does  he/she have special needs:
Daycare/School he/she attends:
   
   
First Name:
Last Name:
Middle Initial:
Date of Birth:
Sex:
Your            Relationship:
Does  he/she have special needs:
Daycare/School he/she attends:
   
   
First Name:
Last Name:
Middle Initial:
Date of Birth:
Sex:
Your            Relationship:
Does  he/she have special needs
Daycare/School he/she attends:
   
   
First Name:
Last Name:
Middle Initial:
Date of Birth:
Sex:
Your            Relationship:
Does  he/she have special needs
Daycare/School he/she attends:



Ask a question or make any comments below:


<Press Submit When finished!




CATAWBA COUNTY PARENTING NETWORK
1005 1st Avenue South
Conover, North Carolina 28613
Phone: 828/ 465-9295
828/ 465-8151
Fax: 828/ 464-7727

 



Convenient Text Links

Main Page  l  Programs  l  Support Groups  l  Finding Us  l  Meet The Staff  l  Contact Us  l  Program Calendar  l  Network Partners
Major Contributors  l  Advisory Board  l  Parent Testimonials  l  Register For Classes Online!
Capital Campaign  l  Giving Options

 
Created in 1999, The Catawba County Parenting Network works to improve the well-being of children and families in Catawba County by providing high quality parenting education and support programs as well as timely referral to other family resources. The CCPN is a program of Catawba County Schools and is primarily funded by the Catawba County Partnership for Children (Smart Start). Additional funding is provided by the Beaver Family Foundation, Catawba County United Way, Catawba Valley Medical Center, The Department of Juvenile Justice, Hickory Public Schools, More At Four Pre-Kindergarten Program and Newton-Conover City Schools.





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