FACES - Registration Form - Concord

All classes are being held at Granite State College, 25 Hall Street, Concord, NH - Event Center

 

        To register, complete the form below:

First Name:
(required)
Full Middle Name:
(If no middle name enter "none")
(required)
Last Name:
(required)
Date of Birth:
(Please use this format: mm/dd/yyyy)
(required)
Mailing Address:
(required)
City:
(required)
State:
(required)
Zip code:
(required)
Home Telephone Number:
(Please use this format: xxx-xxx-xxxx)
(required)
Cell Number:
(Please use this format: xxx-xxx-xxxx)
Business Telephone Number:
(Please use this format: xxx-xxx-xxxx)
Primary E-mail address:
(required)
Re-enter Primary Email
I am:
(required)
Location of District Office
or name of Private Agency:
(required)
Location of District Office or
name of Private Agency:
(required)
Other (specify role):
(required)

Concord Series

Please select each class you plan to attend by checking each individual box.

Orientation: 2/23/18

Friday, 9am-Noon

 Regulations: 2/23/18

Friday, 12:30pm-3:30pm

The Developing Child: 3/6/18

Tuesday, 9am-Noon

The Effects of Childhood Trauma: 3/6/18

Tuesday, 12:30pm-3:30pm

Experiencing Grief & Loss: 3/9/18

Friday, 9am-Noon

Promoting Positive Behavior: 3/9/18

Friday, 12:30pm-3:30pm

Lifelong Connections: 3/13/18

Tuesday, 9am-Noon

Payment Options