Home » Parent Education » Join the 15 Minute Child Break

Join the 15 Minute Child Break

Please select from the following options, all that apply:
Fields marked with * are required.

I found out about this program: Word of mouth
5th-Grade Parent Alert
Mailing/Email
Past "15-Minute Child Break"

Yes, I want to register for a "15-Minute Child Break" Presentation
Please send me more information

Your Information First Name* Last Name*
Title Organization*
Address* City* County*
State* Zip Code*
Work Phone Fax
Home Phone
Email* Website
Location of presentation (cafe, boardroom, etc.) Number of Individuals
Time (preference: AM/PM)* Date

More Available space will permit a display for resource materials at the site of the presentation.
A television and VCR will be available at the site of the presentation.

Questions & Comments

Sub Navigation

The Partnership for a Drug-Free New Jersey

GetSmartNJ.org

Private Property Ordinances

155 Millburn Avenue | Millburn, NJ 07041 | T 973.467.2100 | F 973.467.2188

Contact Us | Feedback | Additional Resources

LFORM | NJ Web Design

Join the 15 Minute Child Break

Sub Navigation

Main Navigation