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 TIR or LSR WORKSHOP DATE *

TIR Workshop September 10-13, 2018 LSR Workshop September 26-29, 2018

PAYMENT SELECTION *

TIR Workshop: Check or money order for $597 ($547 if payment is made 21 days prior to workshop) LSR Workshop: Check or money order for $497 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