FACES - Registration Form - Dover

All classes are being held at:

Bradley Commons Building- 577 Central Ave, Suite 10, Dover, NH 03820

Parking on street or in rear of building.  Use Central Ave. entrance.

        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)

A valid MAILING ADDRESS is required.

City:

(required)

State:

(required)

Zip code:

(required)

Primary Telephone Number:
Please use this format: (xxx) xxx-xxxx

(required)

*NOTE: Shared email addresses are not allowed. Please use a unique email address for each registration*

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)

FACES - Dover Series

Check the box next to each class you want to register for.

Orientation - 10/2

Tuesday, 6:00pm-9:00pm

Regulations - 10/9

Tuesday, 6:00pm-9:00pm

The Developing Child - 10/16

Tuesday, 6:00pm-9:00pm

The Effects of Childhood Trauma - 10/23

Tuesday, 6:00pm-9:00pm

Experiencing Grief & Loss -10/30

Tuesday, 6:00pm-9:00pm

Promoting Positive Behavior - 11/6

Tuesday, 6:00pm-9:00pm

Lifelong Connections -11/13

Tuesday, 6:00pm-9:00pm

 

Payment Options