The Parent Project Pre-registration Form
Thank you for your interest in The Parent Project.  If you have questions, feel free to call Katie Messmann at 812-275-5754 or you can visit https://parentproject.com/.  We are here to help and you are not alone!  

Complete this pre-registration form.  Your information will be emailed to the class facilitator and they will contact you.   Please note: This is just a pre-registration form. Registration is not complete until the class facilitator has confirmed your registration.  If for some reason you have not been contacted, you should contact Katie Messmann at 812-275-5754.
Sign in to Google to save your progress. Learn more
First Name *
Last Name *
Street Address *
City *
Zip Code *
Email address
Phone Number *
Which program are you interested in? *
Which date for Preparing Our Kids for Success?
Clear selection
If you need child care for your children, please list their ages. (Preparing Our Kids for Success ONLY)
Which date for The Parent Project, Sr-Changing Destructive Adolescent Behavior?
Clear selection
Behaviors you are seeing  *
Required
How did you hear about us?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Lawrence County.

Does this form look suspicious? Report

Google Forms