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Divorce Education Program Registration Form

Space is limited, pre-registration is required. The cost is $80.00 per person. You can use this form to register using a Visa/MasterCard/Discover.

You will receive a confirmation in 5-7 business days or sooner. If you do not receive a confirmation a week before the workshop please call Carol at 781-551-0999 ext. 503.

If you would prefer to register by phone, fax or mail, please click here.

Note: Our program is presented in Dedham or Norwood in alternating months. Be sure to be aware of which program you are signing up for.

 PLEASE NOTE: By law, parents of the same children cannot attend at the same time.
                          Childcare is NOT provided. Please do not bring children.
Name of parent registering
Name on Card
Visa / MasterCard / Discover No.
Expiration Date 03/2003 format please
Address:
City:
State:
Zip:
Home Phone:
Work Phone:
E-mail Address:
Fax Number:
Name of other parent:

Dates of Seminar:
REGISTRATION WILL BE CONFIRMED BY MAIL IF TIME PERMITS. OTHERWISE YOU WILL BE CONTACTED BY PHONE OR EMAIL. IF YOU HAVE NOT RECEIVED CONFIRMATION A WEEK IN ADVANCE OF THE PROGRAM PLEASE CONTACT CAROL AT CMANISCALCO@CFPSYCH.ORG OR 781-551-0999 X503.
                            

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Child & Family Psychological Services, Inc.
89 Access Road, Unit 24
Norwood, MA 02062

Child & Family Psychological Services, Inc.
160 Commonwealth Ave, U3 
Boston, MA 02116

Child & Family Psychological Services, Inc.
639 Granite Street, Suite 414
Braintree, MA 02184

Child & Family Psychological Services, Inc.
100 Jeffrey Avenue
Holliston, MA 01746

Offices Also in Abington and Newton

Psychotherapy, therapy, mental health, counseling, career counseling, psychiatrist, psychologist, counselor, ADHD, psychological testing, neuropsychological testing, anxiety, depression, neuropsychology, Spanish neuropsychological testing, bilingual neuropsychological testing, career development, career evaluation, learning disabilities, behavioral medicine, sickle cell, hypnosis, pain treatment, behavior therapy, family therapy, child therapy, behavioral consultation.