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Three easy ways to register!

Print the Registration Form:

______________________________________________

Coping with Divorce 
Registration form

Name;______________Sex______Age________

Address_____________________Phone____________

City______________________Zip___________

Email_______________________

Birthdate M/Year only  _____-_________

Ages of Children__________How Long Married____

How long Seperated_______

How did you here about us_________

Pre Registration is Encouraged 

I am enclosing  $100 pre registration 

I am enclosing  $130 at the door

I am enclosing  $80 as an alumnus

Make check payable to 
FULL CIRCLE COMMUNITY

10358 N 12th Street 
Plainwell MI 49080
________________________________________________

Mail
with your check payable to FULL CIRCLE COMMUNITY to:

Full Circle Community

DirectorDirector of Coping with Divorce
10358 N 12th Street, Plainwell  49080

Bring
the completed form with your check to the registration desk the first night of the seminar.

OR

To register by phone
or for further information contact:
Terry Herr
(269) 998 3826




Please leave a message.


The Seminar is limited to 60 persons.  

Please Register Early!
The cost of the 10 week seminar is:
$100 if mailed prior to the start date
$130 registration at the door
$80 if an alumnus (prior attendee)

Registration Fee includes seminar materials and refreshments.
Limited financial assistance is available. Call Terry, or ask at the registration desk the first week of the seminar.

Please note: When filling out the registration form, we will be asking you for some personal information such as your age, age of your children, how long you've been physically separated, etc. This information is needed so that we can place you in the small support group of people with similar demographics.

ALL INFORMATION SUPPLIED TO US IS KEPT STRICTLY CONFIDENTIAL!!