FCCY Training Series Registration Form

To register for FCCY Training Series classes, please print registration form and mail registration and check ($5.00 per half hour) to:

Make check payable to: Family Care for Children & Youth, Inc.

If you require additional information on the Family Care for Children & Youth Training Series, call (570) 522-9790.

Name/Position: _____________________________________________

Agency: ___________________________________________________

Address: __________________________________________________

City: ____________________________________

State: ______ Zip: _________________________

Phone: __________________________________

E-Mail: __________________________________

We thank you for your interest in the Family Care for Children & Youth Training Series.