SMART Recovery Training Registration – SMART Recovery Training Registration

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* marks required items

TRAINING OFFERINGS

PARTICIPANT INFORMATION

First name *

Last name *

Primary Email *

Confirm Primary Email *

Secondary Email (optional)

Phone *

Address *

City *

Country *

State/Province *

Postal code *

Brief introduction to be shared with the group, including how you found SMART, why you desire to start a meeting, and anything else you wish to share *

Date of Birth *

Are you a Treatment Professional? *

Yes

Please choose the option(s) that best describe why you are completing the training: *

I am planning to start a new meeting

I am planning to assist with an existing meeting

I am (or am planning to be) an online volunteer

I am already an affiliated volunteer but have not been through training yet

I am a professional planning to use SMART Recovery skills with my clients

I am a professional planning to use SMART Recovery with my clients in a meeting setting

Other (Please describe)

We're often asked by various funding sources for information on the demographics of our participants. While optional, this information is helpful to our organization. Any information collected will be presented in total context and individual information will not be shared externally. Thank you for your help!

Present Gender

Sexual Orientation

Race

Ethnicity

Education

Household Income

BILLING DETAILS

Same as above

First name *

Last name *

Bill to company name

Email *

Phone *

Address *

City *

State/Province *

Postal code *

Country *

PAYMENT

Promo Code?

Credit Card *

Expiration *

CVV *

I acknowledge my registration fee is non-refundable*

I accept the Terms of Service (read here)*

TRAINING OFFERINGS

PARTICIPANT INFORMATION

YOUR SMART MEETING

BILLING DETAILS

PAYMENT