PARENT INFORMATION CLASS REGISTRATION FORM The Guidance Center will notify you of the time and location of the class within ten days after receiving your completed registration form. Please mail or deliver a copy of your registration form to: The Guidance Center Attention: Jeanne Arete, Court Services Case Manager 2187 N. Vickey Street Flagstaff, AZ 86001 The cost of the class is $40. You may pay for the class before the day of the first class or when you sign in for the class. You may request a waiver of the class fee at the Coconino County Superior Court Clerk’s Office if you are on public assistance or AHCCCS. If you have any questions, please call Jeanne Arete at 928-714-5304. (1) Case Number: (2) Is there a dispute regarding custody or visitation of the children? [ ] Yes [ ] No (3) Number of children under the age of 18: (4) Petitioner’s Name: Address: Home Phone: Attorney’s Name: (5) Respondent’s Name: Address: Home Phone: Attorney’s Name: Work Phone: Work Phone: Generally, parents go to separate classes. However, if you want to attend the same class, please sign below. agree to attend parent information classes with the other parent, I understand I have the option to attend separate classes, but I choose to attend jointly. There is no history of domestic violence in our relationship. (6) I, (7) Date: Revised October 2006 Signature: Coconino County Alternative Dispute Resolution American LegalNet, Inc. www.FormsWorkflow.com