Human Services Online Submission Forms

LYON COUNTY HUMAN SERVICES
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Parenting Class Registration Form

  1. Lyon County - white background

  2. Lyon County Human Services

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

  3. Parenting Class Registration Form

  4. Part 1: Please complete the following:

  5. Preferred method of contact?*

  6. Who referred you?

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

  8. Demographics: (Optional)

  9. Ethnicity:

  10. Part 2: Which class are you registering to attend?

  11. Location:*

  12. Part 3: Read and Initial the following:

  13. No admittance after 15 minutes of class.

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

  15. Leave This Blank:

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