Request edit access
MAT/MAR Workshop Registration
Please fill out the following form to complete your registration for NHCORR's MAT/MAR Workshop, being held on 7/31/21 at the Canterbury Shaker Village from 8:30am-1:00pm.

Please list the homeowner attending, as well as up to one leader from each location (house manager, peer leader, etc.) as well as the address of the home they're representing.

Please submit payment via the PayPal link below. The cost is $15/person for certified residences, and $20/person for non-certified residences.
Email *
Payment (Click circle when payment is completed) *
Representative 1: *
Representative 1 Address: *
Representative 2:
Representative 2 Address:
Representative 3:
Representative 3 Address:
Representative 4:
Representative 4 Address:
Representative 5:
Representative 5 Address:
Representative 6:
Representative 6 Address:
Representative 7:
Representative 7 Address:
Representative 8:
Representative 8 Address:
Representative 9:
Representative 9 Address:
Representative 10:
Representative 10 Address:
Representative 11:
Representative 11 Address:
Representative 12:
Representative 12 Address:
Questions? Drop them in the box below and we'll be in touch!
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of New Hampshire Coalition of Recovery Residences. Report Abuse