Inquiries

Participant's Name
*
Address
*
- Street Address
- Address Line 2
- City
- State / Province / Region
- Postal / Zip Code
- Country
DOB
*
Phone Number
*
Email Address
*
Referred By
*
Next Court Date
*
Select a Choice
*

BIP/AM Registration Form

Fees

All participants are required to complete an intake assessment prior to beginning the class to ensure appropriate placement. The intake fee is $75 and must be paid on the first day of class. Payment must be made in cash, exact amount only.

Program Fees:

BIP Group: $650

Anger Management Groups: $350

Participants are expected to make payments at each group session and bring the curriculum materials provided on the first day to every class. Failure to make timely payments or bring required materials may result in dismissal from the program and/or a $50 fee for replacement materials.

Restorative Counseling Services, LLC

BIP/AM Registration Form

Fees