Sign Up Form

How did you hear about us?
Family/Friend
FE Couple
Doctor/Hospital
DHS
WIC
I saw your billboard
Other

Mothers First and Last Name:*

Fathers First and Last Name:

Best Contact Phone Number:

This number is a: Cell Phone
Home Phone
Work Phone

Alternate Contact Phone Number:

Permission to leave a detailed message or text message(If Applicable)*
Yes
No Email Address:

Street Address:

City:

State:

Couple's Preferred language:*
English
Spanish
Either
Baby's Due Date or Birth Date:

Are the parents of the child currently in a relationship:
Yes
No
Both the mother and father of the child must be over 18, are you both over 18?
Yes
No
What is your preferred day to attend class?
Monday (6:00-9:00 pm)
Tuesday (6:00-9:00 pm)
Wednesday (6:00-9:00 pm)
Thursday (6:00-9:00 pm)
Friday (9:30am-12:30 pm)
Saturday (9:30 am-3:30 pm)
Additional Comments:

* - Indicates a required field.

Family Expectations | 3 E. Main | Oklahoma City, OK 73104 | (405) 639-2054
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Funding for this project was provided by the United States Department of Health and Human Services, Administration for Children and Families, Grant: 90FM0026. Any opinions, findings , and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the United States Department of Health and Human Services, Administration for Children and Families.