Human Services Online Submission Forms

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Parenting Class Registration Form

  1. Lyon County - white background

  2. 620 Lake Avenue Silver Springs, Nevada 89429 Phone: (775) 577-5009, Fax: (775) 577-5093

  3. Preferred method of contact?*

  4. Who referred you?

  5. Separate ages with comma if more than 1 child.

  6. Ethnicity:

  7. Location:*

  8. No admittance after 15 minutes of class.

  9. Children may not be unattended in the building while parents are in class.

  10. Leave This Blank:

  11. This field is not part of the form submission.