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.

Note: 
 Which class are you registering for?
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.
 
 
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  Be A Member Of Parent Talk  l  Register For Classes Online!
Capital Campaign  l  Giving Options

 
The Catawba County Parenting Network is affiliated with Catawba County Schools, Hickory City Schools, Newton Conover Schools, Catawba Valley Community College and Catawba Valley Medical Center.

Created in 1999, the Catawba County Parenting Network is primarily funded by the Catawba County Partnership for Children (Smart Start) and is a program of Catawba County Schools. The Network works with families in Catawba County Schools, Newton-Conover Schools and Hickory Public Schools. Additional funding for the Network is provided by the Beaver Family Foundation, Catawba County United Way, Catawba Valley Medical Center, The Department of Juvenile Justice, The Duke Endowment, More At Four Pre-Kindergarten Program and The Unifour Foundation, Inc.





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