Registration: Responsible Fatherhood All fields are required. First Name: Last Name: Age: Marital Status: ---SingleMarriedSeparatedDivorcedWidowed Address: Phone Number: Email Address: County: ---BakerClayDuvalNassauSt. Johns Are you court-ordered to pay child support? ---YesNo If yes, how much? Do you have arrearages? ---YesNo If yes, how much? Children's names & ages: Is your relationship with your child(ren)'s mother: Good (Talk a lot, and allows me time with my child) Not so Good (Talk only about support payments, and will only allow visits after payment is received) Very Bad (Says bad things about me to my child, and calls the police when I try to visit child) ---GoodNot so GoodVery Bad Have you received a notice from child support enforcement? ---YesNo If yes, date of notice? Have you received a notice from family court? ---YesNo If yes, date of notice? Have you been summonsed to appear in court? ---YesNo If yes, what is your court date? Do you have any warrants? ---YesNo If yes, how many and for what? Check the appropriate service you are seeking: Lawyer Modify payments Reinstate Driver License Reinstate Voting Rights Expunge Records Employment Education Financial Literacy Housing Transportation Health Care/Insurance Fatherhood Classes Domestic Violence Classes Relationship Building Male Responsibility Currently there are two Fatherhood Classes in progress; please select from the following: Wednesday, 3:45pm – 5:00pm, at The Magnolia Project, 5300 N. Pearl St. Thursday, 6:00pm – 8:00pm at The Historic Springfield Community Learning Center 6th St. & Main St., 2nd Floor ---Magnolia ProjectHistoric Springfield If you cannot attend a class during these days and times; what day and times would be more convenient for you? Please enter the following characters before sending: Learn more about the fatherhood program here. For more information or questions about registration, contact Jack Johnson at 904.723.5422 x123 or Marsha Davis at 904.353.2131 x1002.