Sign up for the Empowering Families to Grow Together Online Series

Thank you for being interested in and choosing to be a part of the Empowering Families to Grow Together online skill-building series. This series includes 4 modules in 6 weeks that include family activities in between sessions. Please complete the following information for your registration.

1 Start 2 Complete

Your First and Last Name *

Please provide your first and last name

Your 4th-grade child(ren)'s First and Last Name

Your 5th-grade child(ren)'s First and Last Name

Your 6th-grade child(ren)'s First and Last Name

Your 7th-grade child(ren)'s First and Last Name

Your 8th-grade child(ren)'s First and Last Name

Your Email Address *

Your Phone Number *

Enter your phone number with the area code.

Can we contact you by text message?

Yes

Availability *

Please select one.

I prefer the Monday 7-8 pm session beginning April 20th

I prefer the Thursday 7-8 pm session beginning April 23rd

I can attend either session, just schedule me and let me know

To receive the materials: *

Please select one.

Please email electronic copies of the materials to the email address above

Please mail hard copies of the materials to the address indicated below

Home Address (if you would like materials mailed to your house):

(Street Address, City, Zip Code)

How did you find out about this opportunity?

Child's School

County Extension

Another parent

Other

Please describe the other way that you found out about this opportunity.

Is there anything you would like to tell us?

College of Human Sciences
Department of Human Development and Family Studies

Partnerships in Prevention Science Institute

2325 N. Loop Drive
Suite 6110
Ames, IA 50010

Email: sherryr@iastate.edu
Phone: 515-294-5383
Fax: 515-294-2870

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