Class Registration Form
| Class
Desired |
Cost |
Month
Requested |
Day
of Week Requested |
|
| Expecting Twins and Multiples | ___Individual $30.00 ___Group of 3-7 $125.00 |
|||
| Pre-term Labor Recognition, Prevention Strategies and Treatment |
___Individual $30.00 ___Group of 4-6 $100.00 |
|||
| NICU Care | ___Individual $45.00 ___Group of 4-6 $125.00 |
|||
| Prepared Childbirth | ___Individual $45.00 ___Group of 4-6 $125.00 |
|||
| Breastfeeding | ___Individual $45.00 ___Group of 4-6 $125.00 |
|||
| C Section | ___Individual $45.00 ___Group of 4-6 $125.00 |
|||
| Infant Care/Newborn Care | __Individual $45.00 ___Group of 4-6 $125.00 |
|||
| Introduction to Mother Friendly and Baby Friendly Hospital Initiatives | ___Group of 4-6 $75.00 | |||
| Name | Phone |
|||
| Address | City/State/Zip |
|||
| Due Date | Hospital where you plan to deliver | |||
| Address of Location you wish to hold class (if other than your home | ||||
| OB, Physician, or Midwife | Phone |
|||
Print and fax this form to 313.343.5208, or copy and paste to an email,
and send to sscheiwegp@sbcglobal.net.