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)
Primary Telephone Number:
(Please use this format: xxx-xxx-xxxx)
(required)
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: 5/11/18

Friday, 9:00am-12:00pm

 Regulations: 5/11/18

Friday, 12:30pm-3:30pm

 The Developing Child: 5/18/18

Friday, 9:00am-12:00pm

 The Effects of Childhood Trauma: 5/18/18

Friday, 12:30pm-3:30pm

 Experiencing Grief and Loss 5/21/18

Monday, 9:00am-12:00pm

 Promoting Positive Behavior: 5/21/18

Monday, 12:30pm-3:30pm

 Lifelong Connections: 6/1/18

Friday, 9:00am-12:00pm

Payment Options