The Institute For Co-Parenting Resolution (CPR) Training And Education Courses Tuition and Materials for the 5 hour and 8 hour Course Please check your desired Course _____ The Five Hour Course The fee for the Course: $50.00 per parent or $95.00 for two parents. If you pick up your course at your local Co-Parenting Facilitator, there is no charge for shipping and handling. Otherwise, there is a $9.00 charge to ship the materials to your home. Course Materials: Five CDs ( 2 on Psychological Issues, 2 on Legal and Co-Parenting Issues, and 1 CD on The Kerman Co-Parenting Plan in Word and WordPerfect formats) CPR Training Manual Evaluation Form CPR Exam Certificate of Completion
_____ The Twelve Hour Course ( follow-up course to the Five Hour Course) The fee for this Course is $75.00 per parent. If you pick up your course at your local Co-Parenting Facilitator, there is no charge for shipping and handling. Otherwise, there is a $9.00 charge to ship the materials to your home. Course Materials: Two DVDs (1 by Guy W. Jordan, Ph.D. who reviews the 28 co-parenting problems and 1 by Arline S. Kerman, J.D., Ph.D. who reviews the Kerman Co-Parenting Plan). The Workbook that contains four lessons, which include reviewing the Checklist For Supportive Management Of Co-Parenting Problems, the Application of Psychological Issues, a discussion of The Kerman Co-Parenting Plan, and the Resolution Conference to resolve child-related issues. Certificate of Completion
CO-PARENTING FACILITATORS (Attorneys, Mediators, Mental Health Professionals, and Spiritual Leaders): ___ $245.00 REFERENCE MATERIALS FOR CO-PARENTING FACILITATORS: Five CDs (2 CDs on Psychological Issues, 2 CDs on Legal and Co-Parenting Issues and 1 CD on The Kerman Co-Parenting Plan in Word and WordPerfect formats) CPR Training Manual Twelve Hour Workbook with Two DVDs (1 by Guy W. Jordan, Ph.D. who reviews the 28 co-parenting problems and 1 by Arline S. Kerman, J.D., Ph.D who reviews the Kerman Co-Parenting Plan) Evaluation Form 90 minute live Teleseminar Certificate of Completion Continuing Education Credits: 6.5 CLE (Attorneys in Georgia); 6.5 CE (Registered Mediators in Georgia); 6.5 CE (Licensed Clinical Social Workers in Georgia)
Name of Registrant: ________________________________________________________________ Address: _________________________________________________________________________ City, State, & Zip Code: ______________________________________________________________ Date of Birth: _________ Phone Number: ___________________________ Cell Number: _________________________ Fax Number: ___________________ Email Address: ________________________________________________________________ If Parent: Relationship to Child(ren): ____________________________________________________________________________ If Professional (Attorney, Mediator, Mental Health Professional, Spiritual Leader): Designation and License Number: __________________________________________________ Payment Information: ____ Visa _____ MC _____ AMX Card Number: ___________________________________ Name on Card: _________________________________________________ Three or Four Digit Number on Card: _________________________________ Exp. Date: _________________ Amount charged: _____________________ Signature: ___________________________________________________________________ _____ Check enclosed payable to The Institute For Co-Parenting Resolution _____ Register by: Telephone: (770) 534-5262 or Fax: (770) 642-1104 _____ Mail Checks to: The Institute For Co-Parenting Resolution, P. O. Box 720, Gainesville, Georgia 30503.