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Form for parenting groups and parenting classes
based on Relief for Hurting Parents...
Please complete as much of the following form as possible. If you do not want specific information disclosed, please indicate which
items in the additional comment area. We need at least one contact phone number for each group or class.
Sponsoring organization:
Statement of purpose:
Which best describes your organizaiton:
group
class
both
Facilitator(s):
Contact person:
(First and Last Name):
Contact primary phone number: Best time to call:
Contact alternate phone number: Best time to call:
Contact mailing address:
(Please included City, State or Province, Zip, and Country if outside the U.S.):
Contact e-mail:
Meeting place:
Meeting place address:
(Please included City, State or Province, Zip, and Country if outside the U.S.):
Near what landmark:
Meeting time:
Meeting day:
Duration of meeting:
Does your group or class use Relief as the primary text as required?
Yes No
Can new parents, grandparents, or guardians start at any time?
Yes No
Is there a volunteer a new parent, grandparent, or guardian can call for support between meetings?
Yes No
If yes:
First Name: Last Name:
Address:
(Please included City, State or Province, Zip, and Country if outside the U.S.):
Primary phone number: Best time to call:
Alternate phone number: Best time to call:
E-mail:
Additional information or comments:
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