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Class Registration 2018/2019 May 6th - June 28th
Welcome to Registration

Secure Beginnings Class Registration

May 6th - June 28th

Thank you for your interest in our programs!

If you have any questions or concerns, please do not hesitate to email us at programs@nantolbert.org or call (805)646-7559 x3.

 

Please select the class(es) below that you would like to register for:

If you are registering more than one child please complete a separate registration form for each child.

If the class you registered for is full you will be added to our waitlist, we will contact you to discuss other classes that might work for you and your family.

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Please note: We collect demographic information for Grant writing purposes and to understand the populations which we serve. Your name and information will never be shared.

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Please check all that apply.

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Primary Caregiver and Household Information
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First Name
Last Name
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
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Please check all that apply.
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First Name
Last Name
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Intake Survey

Please rate the extent to which you agree or disagree with each of the following statements:

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All services are available on a sliding scale, based on your income, and we offer free introductions to our groups. Please check one of the boxes below and we will contact you to make a plan that works for your family. Our scholarship program follows the guidelines provided by Ventura County HUD http://www.ahacv.org/income_limits.shtml

Please upload a copy of your most recent tax return, W2, and/or 1099 form(s). If you are unable to upload, you can email to programs@nantolbert.org, or mail to P.O. Box 285 Ojai CA, 93024
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