Children's Aid & Family Service

Divorce Seminar Registration Form
Printable Version (Opens in New Window)

Items of Special Notice

• Classes fill up one to two months in advance.
• If you do not receive a confirmation from this agency within one week of the date you mailed in your registration,
  please call us at (978) 345-4147.
• Failure to attend or cancel your scheduled class at least
  seven days in advance will result in forfeiture of your fee.
• If you miss the first day of class you will need to
  reschedule by contacting the office.Do not attend Day 2.
• This is a two-day seminar. Participants
  must attend both days.
• This is an educational seminar and is not covered by insurance.
• We cannot issue certificates of completion to
  participants who miss more than 60 minutes of the class.

NOTE:The Commonwealth of Massachusetts has mandated
that SPOUSES DO NOT ATTEND THE SAME SEMINAR.

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Important – each participant must complete
a separate registration form

I would like to register for these seminar dates:

1^st choice ____________2^nd choice___________

Name:__________________________________

Date of Birth:_____________________________

Address:________________________________

City:___________________________________

State:____________ Zip:__________________

Phone Number:__________________________

IMPORTANT:

Name of Spouse of Parenting Partner:

_________________________________________

Date of Birth:_____________________________

*If partner’s name is not provided,
this form will be returned to you.

In accordance with the Commonwealth of Massachusetts
mandate, PARTNERS WILL BE SCHEDULED FOR SEPARATE WORKSHOPS.

Make checks, in the amount of $80.00 (per participant),
payable to: The Family Counseling Center

Please do not send cash by mail.

Send this registration form and payment to:

Children’s Aid & Family Service, Inc.
915 South Street
Fitchburg, MA 01420

Payment may also be made in advance using your VISA,
MasterCard, in person at our office or by phone.

Enrollment is confirmed on a first come/first served
basis upon receipt of payment. Registration will not be
accepted with out payment. 

You will receive confirmation of your enrollment by mail
together with workshop time and exact location.

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81 Hope Avenue, Worcester, MA 01603  Tel 508.755.2340  Fax 508.849.3882  TTY 508.890.5584
Copyright © 2006 Seven Hills Foundation. All Rights Reserved.