7 Habits Series: REGISTRATION DEADLINE: Friday, January 10, 2014 (Space is limited)

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7 Habits Series Registration (UNCLASSIFIED) …

7 Habits Series Registration (UNCLASSIFIED)

Classification: UNCLASSIFIED
Caveats: NONE

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Come join us for our Inaugural 7 Habits of Highly Effective Teens & 7 Habits of Highly Effective Families/Adults Series facilitated by Kara B. Coleman & Mark Richards (State Youth Program) & Chaplain Leslie Nelson (Joint & Family Services):

Workshop Series:
Open to Georgia National Guard Service Members, dependents, & Department of Defense Employees.

Dates: 4 sessions: Tuesday’s: January 21, 28; February 4, 11, 2014

Time: 5:30PM to 7:00PM

For: Youth ages 12-18, Families & Adults
Location: Clay National Guard Center
1000 Halsey Avenue
Marietta, GA 30060

POC: Kara B. Coleman 678-569-5860

REGISTRATION DEADLINE: Friday, January 10, 2014 (Space is limited) ***Dinner will be served each workshop 5:30-6:00PM***

Please see the attached flyer and registration forms and send your registration in. If you have any questions or concerns, please let me know. Thank you in advance and have a great day!


Kara B. Coleman, MSW, LCSW
Child & Youth Services Director
Georgia National Guard
Family Program Office
CNGC 1000 Halsey Avenue, BLDG 447
Marietta, GA 30060
Office: 678-569-5860
Cellular: 404-308-2208
Fax: 678-569-3910
www. GeorgiaGuardFamilyProgram.org/youth

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  • 1. 7 Habits for Highly Effective Families/Adults Registration REGISTRATION DEADLINE: Friday, January 10, 2014 (Space is limited) **Please complete one registration per family or one per person; teen registration is a separate form** Dates: 4 sessions; Tuesday’s-January 21, 28; February 4, 11, 2014 Name(s): __________________________________________________________ Number Attending: _________ Family member’s service information: Service Branch Component Deployment Status □ □ □ □ □ □ Active Duty □ National Guard □ Reserves □ Currently deployed □ Recently returned □ Deployment pending Air Force Army Coast Guard Navy Marines □ Department of Defense Employee Contact Numbers: ___________________________ __________________________ Cell Number Back-up Emergency Number Email Address: ______________________________________ PHOTO/PRESS RELEASE: I understand the Georgia National Guard Joint & Family Services is developing photographic and multimedia materials, which will illustrate events occurring throughout the year for the program. I grant the Georgia National Guard Joint & Family Services and its associated staff and subordinate entities the right to take, use, reproduce, assign and/or distribute photographs, films, non-confidential information, videotapes and sound recordings of the program participants, for use in any such materials as the National Guard Joint & Family Services or its associated entities may create, without any payment to or future approval by me. I concur that there shall be no payment for such use. ____________________________ Parent or Legal Guardian Signature _____________ Date **Please send completed registration form(s) no later than Friday, January 10, 2014 to kara.b.coleman2.nfg@mail.mil**
  • 2. 7 Habits for Highly Effective Teens Registration REGISTRATION DEADLINE: Friday, January 10, 2014 (Space is limited) **Please complete one registration per person** Dates: 4 sessions; Tuesday’s-January 21, 28; February 4, 11, 2014 Teen Name: __________________________ Date of Birth: _____________Age:____ Parent/Guardian Name: _________________________________________________ Contact Numbers: ___________________________ __________________________ Cell Number Back-up Emergency Number Email Address: ______________________________________ Gender M _____ F _____ PHOTO/PRESS RELEASE: I understand the Georgia National Guard Youth Program is developing photographic and multimedia materials, which will illustrate events occurring throughout the year for the Youth Program. I grant the National Guard Youth Program and its associated staff and subordinate entities the right to take, use, reproduce, assign and/or distribute photographs, films, non-confidential information, videotapes and sound recordings of the Georgia National Guard Youth Program participants, for use in any such materials as the National Guard Youth Program or its associated entities may create, without any payment to or future approval by me. I concur that there shall be no payment for such use. ____________________________ Parent or Legal Guardian Signature _____________ Date **Please send completed registration form(s) no later than Friday, January 10, 2014 to kara.b.coleman2.nfg@mail.mil**