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 *

March 9-12, 2018

SELECT PAYMENT *

Other (please explain in comment box below) TIR Workshop: Check or money order for $597 ($547 if payment is made 14 days prior to workshop)

Comment *

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 or fax) Fax to 207-362-6111. Please send payment to address above.

SUBMIT

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