Superior Court of California, County of Humboldt Appendix 8.25 Local Form CCV-8.1 A Local Non-Profit Counseling Agency 1802 California Street, Eureka, CA 95501 Phone: (707) 443-7358 Fax: (707) 443-1092 Children of Divorce Workshop Registration Instructions: Please fill in the information requested below. Return this form with either a check for $50.00 (per person) or a current fee waiver, filed with the court within the last six months that contains all updated information about your income and expenses. Please do not send cash through the mail. Make checks or money orders payable to either Humboldt Family Service Center or HFSC. Mail to: HUMBOLDT FAMILY SERVICE CENTER 1802 CALIFORNIA STREET EUREKA, CA 95501 DATE: _______________ NAME: ______________________________________________________________________ ADDRESS: ___________________________________________________________________ CITY: __________________________________________________ HOME PHONE: ___________________________ ZIP: _______________ WORK: _________________________ If you wish to be in a separate workshop from your spouse or domestic partner, please write spouse or domestic partner's name here: ______________________________________________________________________________ Dates of the workshop are kept confidential until you are registered. This registration form is valid to re-register for a maximum of six workshops or until you no longer qualify for a fee waiver. Adopted for Mandatory Use Children of Divorce Workshop Reg. Form CCV-8.1, Eff. 07/1/13 132 American LegalNet, Inc. www.FormsWorkFlow.com