The Center for Cognitive E Ducation, LLC

The Center for Cognitive Education, LLC. Temple Office: 2027 S. 61st Street, Suite #123 Temple, Texas 76504 (Main Office – Georgetown: Ph. 512-868-9644) Website: www.theccedu.org

Batterers Intervention and Prevention Program (BIPP) Temple Office Referral Form Revised 12-22-11

DATE OF REFERRAL:______CLIENT NAME:______

CLIENT REFERRAL SOURCE NAME/TITLE: (e.g., Probation/Parole Officer, County Attorney Office, CPS worker, etc) :______

Provide the completed referral form to the client and advise them to be at the above address on the date you specified. The client must arrive on time, have the required $40 fee, and will need to present this form to the facilitator upon arrival to the Orientation. Clients who arrive late and/or without the minimum fee for the manual will be advised to report the following week.  Batterers Intervention and Prevention Program (BIPP) Orientation Date: Thursday ______, Time 6:00pm. Orientation for BIPP does include: signing of contract; view of basic concepts; view of program structure; client being assigned a weekly class and purchasing of workbook. Approximate length of the Orientation is 1 ½ hour. $40 is required for attendance at Orientation ($20 for orientation and $20 for manual).

 The Batterers Intervention and Prevention Program (BIPP) is 24 week (at minimum) program; 1 ½ hour weekly group; Cost $25 per weekly group.

NOTE: Please e-mail the group facilitator, Robert L. Jackson, at [email protected] with the name and date client is to attend the Orientation. Confirmation of client attendance will be emailed to you. Advise client of program cost (cash and/or money order. checks are not accepted). Receipts provided upon request.

DIRECTIONS: From Belton Take Loop 363/57th Street Exit and cross over the bridge, turn left at the light. Turn right on 61 st Street. This is the street on which Lacks Furniture Store is located. Travel to the last office complex on your right and enter the parking lot. Enter the complex on your left about mid-way into the parking lot. Suite #123 is in the alcove of the building. From Loop 363 (Temple Mall area) Take the 57th street exit. Stay on access road through the traffic light. Turn right on 61st Street. This is the street on which the former Lacks Furniture Store is located. Travel to the last office complex on your right and enter the parking lot. Enter the complex on your left about mid-way into the parking lot. Suite #123 is in the alcove of the building.

Refer to our web site (www.theccedu.org) for information on additional services currently being offered by the Center for Cognitive Education. Send an email through the “Contact Us” section if you have any questions. Thank you.