Register for Parenting Coach Training

Please print and mail this form with payment to:
Parenting Coach Certification Registration
Center for the Challenging  Child
2233 University Ave. W., Suite 325
St. Paul, MN 55114
Checks for $3300 ($2900 early bird special) are payable to Center for the Challenging Child.

Today’s Date:              __                                            Course Start Date: ________

Name:                                         _________________             ____________      __________________________            

Address:                                                                                                                          ___                                  ______       

 

Email:                                                                                         ________________________________________      

 

Phone:                                                                  _________________________________________                          

 

Educational Background:

I have a four-year degree in (field)

_______________________________________________________________________________________

from (institution of higher learning)

_______________________________________________                                                                   ________       _


Equivalent Experience and/or Current Work:

_______________________________________________________________________________________

_______________________________________________________________________________________

 

How do you intend to use your Parenting Coach Certificate?

 ______________________________________________________________________________________

______________________________________________________________________________________

 

Thank you for your registration. We look forward to meeting you at the upcoming Parenting Coach Training!

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