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Co-Parenting Zoom Class for Ashland & Bayfield County Residents

2. Co-Parenting Class Via Zoom
   An internet connection, video camera, microphone and active participation is required to certify course completion.

   An internet connection, video camera, microphone and active participation is required to certify course completion.

4. I would like to register for the following class:*

   1. Thursday, October 29, 2020 - 4 pm - 7 pm, Online via Zoom live video conference
   2. Tuesday, December 1, 2020 - 9 am to Noon

6. First Name*

7. Last Name*

9. Mailing Address*

11. City*

12. State*

13. Zip*

15. Phone Number*

16. Cell phone or Landline*

    1. Cell Phone
    2. Land Line
17. Email Address*

19. Name of Other Parent
    We request this information so we can let you know if the other parent registers for the same session. Instructor permission is required for both parents to enroll in the same session and priority is given to the registration received first. In the event the other parent registers, we will contact you to discuss this option.

    We request this information so we can let you know if the other parent registers for the same session. Instructor permission is required for both parents to enroll in the same session and priority is given to the registration received first. In the event the other parent registers, we will contact you to discuss this option.

21. First Name of Other Parent*

22. Last Name of Other Parent*

24. Are you attending to satisfy a court order or other requirement?*

    1. Yes
    2. No

25. If yes, please indicate the county your case is filed in or the agency involved.*

    1. Ashland
    2. Bayfield
    3. Other

26. If Other, please list.

28. During the COVID-19 Pandemic, Fees for this class have been reduced.

30. Co-Parenting Education

    Zoom Class

31. Price

32. Quantity*

33. Shipping Cost

35. Taxable

37. Continuing with your payment
    After Clicking "Proceed to Check Out", you will be directed to the Bayfield County E-Payment Center. If you have an account, you may either log-in OR Proceed as a guest (No Log-in) by clicking on the "Proceed to Check Out." You will continue to the next page.

    After Clicking "Proceed to Check Out", you will be directed to the Bayfield County E-Payment Center. If you have an account, you may either log-in OR Proceed as a guest (No Log-in) by clicking on the "Proceed to Check Out." You will continue to the next page.

39. You will LEAVE the Bayfield County website.
    You will leave the Bayfield County site and be redirected to a PayPal site to continue the checkout process. You will either login to your PayPal account or click on the gray button to pay with a debit or credit card. You will be on the PayPal site. You will be directed to enter your payment information. Thank You.

    You will leave the Bayfield County site and be redirected to a PayPal site to continue the checkout process. You will either login to your PayPal account or click on the gray button to pay with a debit or credit card. You will be on the PayPal site. You will be directed to enter your payment information. Thank You.

41. For more information or an alternate option to register, contact:
    Extension Bayfield County Educator Liz Lexau at 715-373-3288 or elizabeth.lexau@wisc.edu. or Extension Ashland County Educator Heidi Ungrodt at heidi.ungrodt@wisc.edu

    Extension Bayfield County Educator Liz Lexau at 715-373-3288 or elizabeth.lexau@wisc.edu. or Extension Ashland County Educator Heidi Ungrodt at heidi.ungrodt@wisc.edu

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42. Calculate Totals Proceed to Checkout

* indicates a required field