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.