Event and Workshop Registration Form
PERSONAL INFORMATION
* First Name:
* Last Name:
Company Name:
Title:
* Email Address:
* Address:
* City:
* State:
* Zip:
* Daytime Phone:
Evening Phone:
Fax:
Other Phone:
* How may we contact you?
Phone
Postcard
Email
Fax
* All calls placed from our office show as private on caller ID. Due to confidentiality laws, when we contact you (via phone, email, postcard, fax, etc.) regarding your registration, may we identify ourselves as a representative from CARE?
Yes
No
Yes, I would like to receive CARE's FREE newsletter, Stepping Stones.
How did you hear about us?
Attorney
At work
Church
Court
Employer
Flyer
Friend
Library
Newspaper
Not specified
Prior participant
Professional referral
Radio
School
Television
Website
Comments:
Be sure to check the checkbox in the top left of every event and workshop you want to attend.
REGISTER FOR EVENTS
More Info
8th Annual Tea & Luncheon
on Sunday, September 19, 2010 at Barrister Gardens, 24225 Harper, St. Clair Shores 48080
Cost:
$40.00
Tickets:
1
2
3
4
5
Name on Ticket #2:
+ $40.00
Name on Ticket #3:
+ $40.00
Name on Ticket #4:
+ $40.00
Name on Ticket #5:
+ $40.00
More Info
8th Annual Tea & Luncheon - Friend of CARE
on Sunday, September 19, 2010 at Barrister Gardens, 24225 Harper, St. Clair Shores 48080
Cost:
$100.00
Tickets:
1
2
3
4
5
Name on Ticket #2:
+ $100.00
Name on Ticket #3:
+ $100.00
Name on Ticket #4:
+ $100.00
Name on Ticket #5:
+ $100.00
More Info
Spotlight on Safety Conference 2010
on Thursday, September 30, 2010 at Assumption Cultural Center, St. Clair Shores
Cost:
$79.00
Tickets:
1
2
3
4
5
Name on Ticket #2:
+ $79.00
Name on Ticket #3:
+ $79.00
Name on Ticket #4:
+ $79.00
Name on Ticket #5:
+ $79.00
More Info
Quarterly Leadership Link & Learn (L3)
on Thursday, October 21, 2010 at CARE, 31900 Utica RD., Fraser, 48026
Tickets:
1
2
3
4
5
Name on Ticket #2:
Name on Ticket #3:
Name on Ticket #4:
Name on Ticket #5:
REGISTER FOR WORKSHOPS
More Info
Adolescent Anger Management 9-14 years
on Thursday, September 23, 2010 at CARE, 31900 Utica Rd., Fraser
Cost:
$120.00
Tickets:
1
2
Parenting Partner:
More Info
Parenting Young Children-St. John Lutheran 9-23-10
on Thursday, September 23, 2010 at St. John Lutheran Church, 16339 14 Mile, Fraser
Tickets:
1
2
Parenting Partner:
More Info
Parenting Teenagers-Henry Ford Hospital 09-29-10
on Wednesday, September 29, 2010 at Henry Ford Hospital, 13355 E. 10 Mile, Warren
Cost:
$30.00
Tickets:
1
2
Parenting Partner:
+ $15.00
More Info
Parenting School Aged Children-St. Thomas Church 10-04-10
on Monday, October 4, 2010 at St. Thomas Luth Church, 8771 E. 15 Mile, Sterling Heights
Cost:
$30.00
Tickets:
1
2
Parenting Partner:
+ $15.00
More Info
Parenting Young Children-Trinity Lutheran 10-04-10
on Monday, October 4, 2010 at Trinity Lutheran Church, 38900 Harper, Clinton Twp.
Tickets:
1
2
Parenting Partner:
More Info
Parenting School Aged Children-Lobbestael Elem 10-04-10
on Monday, October 4, 2010 at Lobbestael Elem., 38495 Prentiss, Harrison Twp.
Cost:
$30.00
Tickets:
1
2
Parenting Partner:
+ $15.00
More Info
DOT Training for Safety Sensitive Employees
on Tuesday, October 5, 2010 at CARE, 31900 Utica Rd., Fraser, 48026
Cost:
$15.00
Non-Contracted:
$50.00
Tickets:
1
2
Parenting Partner:
More Info
DOT Alcohol & Drug Testing Training for Supervisors
on Tuesday, October 5, 2010 at CARE, 31900 Utica RD., Fraser, 48026
Cost:
$15.00
Non-Contracted:
$50.00
Tickets:
1
2
Parenting Partner:
More Info
Parenting Young Children-McKinley Elem 10-05-10
on Tuesday, October 5, 2010 at McKinley Elementary, 13173 Toepfer, Warren
Tickets:
1
2
Parenting Partner:
More Info
Parenting Teenagers-LCME 10-05-10
on Tuesday, October 5, 2010 at L'Anse Creuse Middle-East, 30300 Hickey, Chesterfield Twp.
Cost:
$30.00
Tickets:
1
2
Parenting Partner:
+ $15.00
More Info
Parenting Young Children-Mt. Calvary 10-13-10
on Wednesday, October 13, 2010 at Mt. Calvary Church, 8129 Packard, Warren
Tickets:
1
2
Parenting Partner:
More Info
Parenting School Aged Children-Hope Church 10-13-10
on Wednesday, October 13, 2010 at Hope United Church, 32500 Utica Rd., Fraser
Cost:
$30.00
Tickets:
1
2
Parenting Partner:
+ $15.00
More Info
Parenting Teenagers-Kennedy MS 10-13-10
on Wednesday, October 13, 2010 at Kennedy Middle School, 23101 Masonic, St. Clair Shores
Cost:
$30.00
Tickets:
1
2
Parenting Partner:
+ $15.00
More Info
Parenting Teenagers-Ford HS 10-14-10
on Thursday, October 14, 2010 at Ford II High School, 11911 Clinton River Rd., Sterling Heigh
Cost:
$30.00
Tickets:
1
2
Parenting Partner:
+ $15.00
More Info
Parenting School Aged Children-King of Kings 10-14-10
on Thursday, October 14, 2010 at King of Kings Church, 47500 Schoenherr, Shelby Twp.
Cost:
$30.00
Tickets:
1
2
Parenting Partner:
+ $15.00
More Info
Adolescent Anger Management 15-18years
on Thursday, November 4, 2010 at CARE, 31900 Utica Rd., Fraser
Cost:
$120.00
Tickets:
1
2
Parenting Partner:
