REGISTER for Anger Management

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PREFERRED METHOD TO CONTACT YOU *
WHY ARE YOU TAKING THIS CLASS? *
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IS THIS CLASS COURT ORDERED? *
IF SO, WHAT COURT? *
REFERRED BY * PROBATION OFFICIER
LAWYER
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PROBATION OFFICER'S NAME?
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PROLBEM LEADING TO DECISION TO TAKE THE CLASS? *
EDUCATION * HIGH SCHOOL COMPLETED
COLLEGE
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I UNDERSTAND THAT PAYMENT MUST BE RECEIVED PRIOR TO THE START OF CLASS.
HOW DO YOU PLAN TO PAY? * CHECK TO STARFISH MEIDATION
CREDIT CARD THROUGH PAYPAL
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MONEY ORDER
CHECK HERE IF YOU WANT CONFIRMATION BY EMAIL OR PHONE OF YOUR REGISTRATION.

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PLEASE EMAIL ( eribas@verizon.net) OR MAIL REGISTRATION  FORM TO STARFISH MEDIATION & TRAIINING GROUP, 435 W BEN OAKS DR. SEVERNA PARK, MD 21146.  WE LOOK FORWARD TO SEEING YOU IN CLASS.  PLEASE EMAIL OR CALL FOR FURTHER INFORMATION.