REGISTRATION FORM

Pre-registration is required

To register online:	Check the session you want to attend and then complete the registration form
To register by mail:	Click HERE to open a registration form that you can print out
To register by phone:	Call 508-366-7557

Payment information will be sent with your registration confirmation

Please select the dates you would like to attend. You may wish to make an alternate selection as sessions fill quickly and dates are subject to change.

January 26 - 27 (Thursday & Friday morning)	9 am - 11:30 am	Fee:  $80
February 23 - 24 (Thursday & Friday morning)	9 am - 11:30 am	Fee:  $80
March 22 - 23 (Thursday & Friday morning)	9 am - 11:30 am	Fee:  $80
April 26 - 27 (Thursday & Friday morning)	9 am - 11:30 am	Fee:  $80
May 25 - 26 (Thursday & Friday morning)	9 am - 11:30 am	Fee:  $80
June 21 - 22 (Thursday & Friday morning)	9 am - 11:30 am	Fee:  $80
July 26 - 27 (Thursday & Friday morning)	9 am - 11:30 am	Fee:  $80
If you selected more than one session, we will assume that the earliest date is your preference. If that is not the case, please indicate your first choice of dates.

Please complete the registration form. Click on Register Now! at the bottom when you are finished.

Please keep in mind that the probate court has decided that soon-to-be ex-spouses are not allowed to take this class together. Priority is given to the enrollee who completes the registration and makes their tuition payment first.

First name:
Last name:
Street address:
City:		State:		Zip:
Email address:
Check here if you would like to be added to our email list to receive future flyers, parenting tips, and more!
Home phone:
Work phone:
Cell phone:

 

Please provide the following additional information:
Ex-spouse full name:
Docket number (if known):
Referred by:
Probate Court:
Attorney or Mediator:
Is there a Restraining Order?	Yes   No
Special Needs or Requests:

 

Please select the payment method you will use:
I will mail payment in advance. I will pay with cash or by check at the session.
If you are paying in advance, please send payment to:
	Sylvia Sirignano, Ph.D. Parenting Solutions 6 Colonial Drive  Suite 2 Westborough, MA  01581
How would you like to receive confirmation of your registration?
Send confirmation by emailSend confirmation by mail
Feel free to provide any additional information.

Please go Back to the Top and review all information prior to submitting your registration.

If you are ready to register please print this page for your records.

When you are ready, click below to send us the registration form. Please be patient, your registration may take a few moments to process.