Programme Registration Form – Community Building Parenting

This form may be filled out and returned online using Adobe Reader. Or please print, fill out and return to: SFSC Administrator, Race Equality Foundation, UK. The completed form may also be returned to the Foundation by email: info@cb-parenting.com or by phone: 0789 460 0003

Agency details

Agency name *

Address *

Postcode *

Contact name *

Phone *

Facilitator details

Name (1) *

Phone *

Email *

First time facilitator? (Please tick) *YesNo

Name (2)

Phone

First time facilitator? (Please tick)YesNo

Programme details

Address where programme will take place *

Postcode *

Phone *

Number of parents recruited *

Day of week *

Programme start date (Day/Month/Year *

Programme end date (Day/Month/Year) *

Hours *

Minutes *

s the group open to all parents? (Please tick) *YesNo

If no, please state which specific group is targeted? *

Postcode *

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