*You must have access to a computer/smart phone/tablet with a camera and microphone Full Name, as appears in case: * Case Number: * Phone Number: * E-Mail: * Remote Seminar Requested (only available dates are listed): * Saturday, July 20, 2024 9:00 a.m. Saturday, August 17, 2024 9:00 a.m. Saturday, September 21, 2024 9:00 a.m. Is there a protection order between the parties? * Yes No Physical address at which you will be located when attending the virtual class. * City/State/Zip: * In case of a medical emergency, who is the local emergency responder to that address? * Leave this field blank