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Co-Parenting Resolution
Parent/Professional Registration
 


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.                         

 
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