Workshop Registration

TIR Institute of Maine

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

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Name *

First

Last

Address *

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City

State

Zip Code

Country

Email *

Phone Number *

Please SELECT your preferred WORKSHOP DATE(s) *

TIR Workshop January 24-27, 2020 TIR Expanded Applications Workshop February 21-24, 2020 LSR Workshop March 20-23, 2020 TIR Workshop April 24-27, 2020 TIR for Children May 11-12, 2020

PAYMENT SELECTION Check all that apply *

Any 4-day Workshop: Check or money order for $597 (regular price) Any 4-day Workshop: $547 if paid-in-full 30 days prior to workshop start date TIR for Children: $397 if paid in full 30 days prior to the start date of this 2-day workshop A combination of one or more workshops chosen by one or more persons registering at the same time (but each person must register separately), $100 discount for each workshop I will be paying by check or money order (Please submit to address below) I will be paying by credit card or PayPal (Please make selection below) OTHER Please explain below

Check all boxes that apply

Other Payment Information *

SUBMIT

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

WORKSHOP PAYMENT

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