FACES - Registration Form - Manchester

FaithBridge Church

301 S. Main St.

Manchester, NH 03102

 

 

        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)
Home 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 Email Address
(required)
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)
If you have a disability which may require special services, please check here.
Please explain your accommodation needs.
(required)

FACES - Manchester Series

Check the box next to the class(es) you are registering for

Orientation: 6/2/18

Saturday, 9:00am-12:00pm

 

Regulations: 6/2/18

Saturday, 12:30pm-3:30pm

 

The Developing Child: 6/6/18

Wednesday 5:30pm-8:30pm

The Effects of Childhood Trauma:  6/13/18

Wednesday, 5:30pm-8:30pm

Experiencing Grief and Loss: 6/16/18

Saturday, 9:00am-12:00pm

Promoting Positive Behavior: 6/16/18

Saturday, 12:30pm-3:30pm

Lifelong Connections: 6/20/18

Wednesday, 5:30pm-8:30pm

By submitting your registration, you have agreed to allow the Education &Training Partnership to share your course participation and completion information with the New Hampshire Division for Children Youth & Families (DCYF).

Payment Options