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Positive Parenting Course Registration Form - Children 6-12
1.
Please enter your full name.
*
2.
KAUST email
(Required.)
*
3.
Google email
(Required.)
*
4.
Your mobile number without the initial zero
(Required.)
5.
Are you:
The mother
The father
Other (please specify)
6.
How many children do you have?
0
1
2
3
4
5
more than 5
7.
Do you have children between 6 and 12 years of age?
No
Yes
8.
Tick all the people who parent/care for your child/children at home?
You
Your Spouse
Hired Help (e.g. nanny)
A Family Member
Other
9.
How many parenting courses have you attended before this one?
0
1
2
3
more than 3
10.
On a scale of 1-5, how confident do you feel in your ability to effectively parent your children?
5 Very confident
4 confident
3 Somewhat confident
2 Unconfident
1 very unconfident
11.
What are your current parenting challenges (e.g. tantrums, toileting, not following adult direction, sibling conflict etc.)?
12.
What parenting strategies (e.g. time-out, ignoring, consequences, quality time etc.) do you currently use in parenting your children?
13.
Are you committed to attending the 4 lunch-time session parenting course and paying the 250 SAR fee for the course, in advance? Yes/No
Yes
No
14.
Is there someone who can attend this course with you who is involving in caring for your child(ren)? If so, what is their name and what is their role (e.g. parent, nanny, grandparent etc.)
