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Info

Parents Chat

A program for Parents

Find out more or register below

Registration Fee: $15

Class Sessions: 6:00pm - 7:00pm Thursdays February 2 - March 1, 2012

E-Mail Address ■

First Name ■

Last Name ■

Student's Name

Address, Apt #, City, State, Zip Code ■

2011 Up Hill Rd. Apt. B Indianapolis, IN 46555

Home Phone ■

317-123-4567

Work Phone

317-123-4567

Cell Phone ■

317-123-4567

How did you hear about CLD? ■

TV/Radio Commercial

My Child's School

A Parent

Indiana Black Expo

HBCU College Fair

IBJ

Indianapolis Recorder

Other

Which CLD Program has your child attended? ■

Select all that apply.

Jr. Self-Discovery/Career Exploration Project

Precious Miss

Project MR

Imani Book Club

Success Prep

Self-Discovery/Career Exploration

College Prep

SAT Prep

Business Orientation Project

Rawls Scholar Medicine Initiative

No

How would you like to pay the registration fee? ■

I understand that by participating in CLD programs I am giving permission to be photographed and recorded for the purposes of ongoing promotion of the CLD organization, programs and events. ■

Registration Fee: $15

CLD is located at 2425 Dr. Martin Luther King Jr. Street, Indianapolis, IN 46208

Office: 317.923.8111 Fax: 317-923-8112

© 2012 Center for Leadership Development, All rights reserved.