PEP Registration with Yardley Associates

Each parent must register separately. Please only complete the registration form for yourself.

If you need help to complete your registration, please call 860-688-1240 at any time, day or night, as our answering service is available 24/7.

As of July 1, 2022, the state requires classes to be offered both in-person and online, with limited online enrollment.

When you sign up for a selected class, please make sure to note whether the PEP class is offered in-person or online.

Sign in to Google to save your progress. Learn more
Email *
First Name (legal name, not nickname) *
Last Name *
Address *
Town/City *
State *
Zip *
Phone Number
How did you hear about our classes? *
If you heard about us from a lawyer, mediator, or service provider, please tell us their name.
Please select the following Parent Education Program that you want to attend: *
The fee for the class is $150. How will you be paying for the class? Select one below. *
If you are paying by Venmo, Zelle, or CashApp, what is your username?
You have the right to attend the class together or separate from any individual. Is there any person who you do NOT want to attend the same class as you? *
If yes, please type in their first name and last name.
Have there been any safety issues, domestic violence, or coercive control concerns between you and your child's other parent? *
If yes, please explain.
Are there currently any active restraining orders, protective orders, or no-contact orders for either parent? *
If yes, please include the type of order and the full first and last name of all individuals on the order.
You are welcome to have an adult guest (over 21 years old) attend the class with you free of charge. Your guest may NOT be another adult who is ordered to take the class NOR can it be one of your children. *
If yes, please include your guest's first name and last name below.  If you signed up for an online class and your guest will be joining from separate device, please include their name AND email address.
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy