Virtual Class Interest Name* First Last Email* Phone*Please select each class series that you would like to register for. Once registered, you will receive the link information to join.* Toddler Class: “I Can Do It Myself” - Thursday, Nov 30 @ 5:30 PM Toddler Class: The Importance of Play - Thursday, Dec 7 @ 5:30 PM Being A Father: Practical Discipline - Thursday, Nov 30 @ 7:00 PM Relational Class: Boundaries - Thursday, Dec 7 @ 7:00 PM Relational Class: Anger Management - Thursday, Dec 14 @ 7:00 PM Relational Class: Domestic Violence - Thursday, Dec 28 @ 7:00 PM Have you ever received services as a client of FirstLook?* Yes No Have you previously attended FirstLook classes in-person or online?* Yes No Date of Birth* MM slash DD slash YYYY An email with the Google Meet link will automatically be sent to you once you submit this form. May a FirstLook representative contact you to complete intake by phone?* Yes No, I will call FirstLook at 469.530.4934 to complete my intake. CAPTCHA Δ
