7 Habits Series Registration (UNCLASSIFIED) Classification: UNCLASSIFIED Caveats: NONE All- 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

2. 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**

3. 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**