Use this page to order full programs only.

If you are purchasing educational materials, go to product registration.

It is required that you agree to our site policies. See Policy - Program. Please read this first. If you leave this page you will lose what data you have entered.

After completing this form click "submit form". Then please check your emails for confirmation and procedural information.

NOTE: NAME AND ADDRESS YOU GIVE US MUST MATCH NAME AND ADDRESS ON CHARGE CARD BILLING STATEMENT.

* Required fields
Name *
E-mail Address *
The name you give us must match the name on the charge card you are using. Please give us the exact name from that card. *
We will be sending you your workbook or materials by email. Please let us know if you want us to use a different email address from the one listed above. If the same, put "same". *
Street Address or PO Box (must match exactly the address on the billing of the charge card you are using) *
City (must match exactly the address on the billing of the charge card you are using) *
State (must match exactly the address on the billing of the charge card you are using) *
Zip Code (must match exactly the address on the billing of the charge card you are using) *
Country *
Telephone number with area code first *
Enter your charge card number (only accepted type of payment) *
Type of charge card (choose Visa, Mastercard, Discover or American Express) *	Visa Mastercard Discover American Express
Expiration Date (mo/yr) *
Enter your charge card verification number. For Visa, Mastercard and Discover, this is the three-digit number on the back of the card after the card number. For American Express, this is the four-digit number on the front of the card above the card number. *
Please indicate items you wish to purchase. Sales tax will be added to price if applicable. *	Anger Management Program 1-8 hrs(sessions) ($100) Anger Management Program 9-12 hrs (sessions) ($125) Anger Management Program 13-16 hrs(sessions) ($150) Anger Management Program 17-20 hrs(sessions) ($175) Anger Management Program 21-24 hrs(sessions) ($200) Family Violence Program 1-8 hrs(sessions) ($100) Family Violence Program 9-12 hrs(sessions) ($125) Family Violence Program 13-16 hrs(sessions) ($150) Family Violence Program 17-20 hrs(sessions) ($175) Family Violence Program 21-24 hrs(sessions) ($200) Family Violence Program 25-28 hrs(sessions) ($225) Family Violence Program 29-32 hrs(sessions) ($250) Family Violence Program 33-36 hrs(sessions) ($275) Family Violence Program 37-40 hrs(sessions) ($300) Family Violence Program 41-44 hrs(sessions) ($325) Family Violence Program 45-48 hrs(sessions) ($350) Family Violence Program 49-52 hrs(sessions) ($375) Parenting Program 1-8 hrs(sessions) ($100) Parenting Program 9-12 hrs(sessions) ($125) Parenting Program 13-16 hrs(sessions) ($150) Parenting Program 17-20 hrs(sessions) ($175) Parenting Program 21-24 hrs(sessions) ($200) Parenting program 25-28 hrs(sessions) ($225) Parenting program 29-32 hrs(sessions) ($250)
Enter court case number if court ordered for this program *
Enter court name and address if court ordered for this program *
Enter probation or parole officer's name, address & phone number if one has been assigned to you if you are court ordered for this program *
Briefly explain incident that caused you to be assigned to do the program if you are court ordered *
Are you suffering from any serious mental health problems, such as severe depression, anxiety, suicidal or homicidal thoughts etc. Please explain. *
Did the incident which caused you to be assigned to do the program involve your use of drugs or alcohol? Please explain *
Briefly explain any previous counseling you have received *
Tell us what you want to learn from this program *
Are you interested in this website's skill support services? *	yes no maybe ///////////////////////////////////////
What equipment will you use to view product? *	Normal sized computer or laptop computer Mobile or handheld device Both
I understand that all products on this site are protected by copyright law and that it is illegal to reproduce, copy and/or distribute for sale any copyrighted product without the permission of the owner of the copyright. I agree to abide by all applicable laws in this regard. Please refer to site's "policy-program" page. *	Yes No

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