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Divorce Recovery Program
Winter 2010 Series
Thursdays - January 28th through March 18th, 7:00 - 9:30 pm
Simply fill out the form below to register.

A pre-registration donation of $30.00 is requested.  After you submit the form below you will be given the opportunity to make the pre-registration donation online as part of the registration process, or you can register online and make your donation later. 

Divorce Recovery Program Registration
Items with * are required
Name:  *
Address:  *
Address 2:  
City:  *
State:  *
Zip:  *
Email:  *
Home phone (eg. 555-123-4567):  *
Work phone:  
Number of times married:  
How long you were married:  
Number of children:  
Ages of children:  
Do you need childcare?
Filed for divorce?
Is your divorce final?
Attended Divorce Recovery before?
If so, where?  
...and when?  


  



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