Department of Community Justice- Family Court Register Online

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Department of Community Justice
Family Court Services
Multnomah County Courthouse
1021 SW 4th Avenue, Room 350 Portland, OR 97204-1184
MAIN: 503.988.3189 ** FAX: 503.988.3232 ** TDD: 503.988.3561

Multnomah County Family Court Services
Parent Education Program Registration Form

Full Name: (As On Legal Document- First, Middle, Last )

Other Names Used:

Date of Birth: (MM, DD, YYYY)

Mailing Address:

City:

State:

Zipcode:

Daytime Phone # with Areacode:

Evening Phone # with Areacode:

Cell Phone # with Areacode:

EMAIL:

Court Case Information:

I am the:

Case is IN Multnomah County

Multnomah Court Case Number: (if none type 00)

Case will be in Multnomah County but is NOT Filed Yet
Case is NOT in Multnomah County

Name of Opposing Parent in the Case:
(Required- First, Middle, Last):

Other Names Used of Opposing Parent in the Case :

Name of Opposing Parent in the Case
Date of Birth: (MM, DD, YYYY)

(Please NOTE: This does NOT sign up the other parent. Submit an additional form if you are ready to sign up and pay for the other parent.)

Attendance Requirement :

Has there been a no-contact Restraining Order between you within the last year?”
Yes No

Has there been any Domestic Violence in this situation within the past year?”
Yes No

Class Preference:
I do NOT want to attend the same class as other parent.

I DON'T CARE if we attend the same class

I WANT to attend the same class as the other parent.

Session Day Preferences (Please check ALL that apply):

Tuesday - Multnomah County Courthouse- 1021 SW 4th Avenue
Room 130- 5:30 PM to 9:00 PM

Thursday - Juvenile Justice Complex- 1401 N.E. 68th Avenue
Room 1201- 5:30 PM to 9:00 PM

Saturday - Multnomah County Courthouse- 1021 SW 4th Avenue
Room 130- 9:30 AM to 1:00 PM

No Preference

Special Needs:
Language Translation needed? Yes No
What Language?

Any Additional Comments or Special Accomodations Needed?

Payments

Name of Person Filling Out Form:
Phone Number:

The Coordinator will call the person submitting the registration to complete the registration and accept payment over the phone via credit card. The seat cannot be guaranteed until the charge has been made on your credit card.