Enroll Now For Our 2010 Workshops!

Enriching Marriages in Indiana Project (EMIP)
P.O. Box 21006
Indianapolis, IN 46221
Physical Address:
849 S. Belmont St.
Indianapolis, IN 46221

Enroll via our online form below.

Enter your personal information.

First Name:		Last Name:
Address #1:
Address #2:
City:		State:		Zip:
Home Phone#:		Cell Phone#:
Email Address:		Married?	Yes No	How Long?
Number of Children:
Yearly Income	0-25K 26-40K 41K+

Check the workshop(s) you are registering for. (All that apply)

Workshop 1	Workshop 2
Workshop 3	Workshop 4
Workshop 5	Workshop 6
Workshop 7	Workshop 8

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