| Name:* |
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| Age: * |
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| Gender: * |
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| Telephone: * |
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| Street Address: * |
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| Zip Code: * |
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| Emergency Contact: * |
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| Telephone (if different than above): |
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| Referred By: * |
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| E-mail Address: * |
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| How did you hear about us?: * |
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| Comments: |
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| Please select at least one: |
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August 3 (Money Management)
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August 10 (Safe Dating)
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August 17 (Back to School)
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August 24- No class
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August 31 (Anxiety/Stress)
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September 7 (Internet Safety)
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September 14 (Life Skills)
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September 21 (Drinking and Driving)
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September 28 (Sexting)
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October 5 (Job Readiness)
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October 12- No class
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Life Skills Classes are held each Tuesday, from 4-5pm, at the Midtown Library on Central Street. Before submitting, pease print a copy of this calendar for your records.
Questions? Call 417-522-4654 |