Workshop Registration

Workshop Registration Please complete this form and submit it to the TIR Institute of Maine.

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number *

Please SELECT your preferred WORKSHOP DATE *

TIR-EA Workshop March 15-18, 2019 TIR Workshop April 12-15, 2019 TIR Workshop May 31-April 3, 2019

PAYMENT SELECTION *

TIR-EA Workshop: Check or money order for $597 ($547 if payment is made 30 days prior to workshop) TIR Workshop: Check or money order for $597 ($547 if payment is made 30 days prior to workshop) ANY Workshop payment made by Credit Card or PayPal choose link below

Please write out your check or money order to: TIR Institute of Maine and send to:
TIR Institute of Maine
PO Box 2
Smithfield, ME 04978

SUBMIT or PRINT ( to mail )

SUBMIT

Crown Cove Counseling office is located at 28 Merry Lane in Smithfield, Maine