Ottawa TIR Workshop April 5-8, 2019 Registration Form
TRAUMATIC INCIDENT REDUCTION (TIR) WORKSHOP
Reesor & Associates
Suite 215, 150 Isabella Street
Ottawa, Ontario
April 5 to 8, 2019, from 8:30 am to 4 pm

Facilitator: Suzanne Franklin Duc, RP, MACP, Certified TIR and LSR Trainer
FEE: $950
EARLY BIRD DISCOUNT: $850 IF FULL PAYMENT RECEIVED THIRTY DAYS BEFORE THE WORKSHOP

For any questions regarding the workshop or registration please call or email Suzanne Franklin Duc at 613-230-0250 X222, suzanne.duc1@gmail.com

METHODS OF PAYMENT:

CHEQUE Please send payments to: Suzanne Franklin Duc,
c/o Reesor and Associates, Suite 215, 150 Isabella Street, Ottawa, ON K1S 1V7

E-TRANSFER Email: suzanne.duc1@gmail.com
Text: 613-698-9707

CREDIT CARD Please contact Suzanne Franklin Duc via e-mail at suzanne.duc1@gmail.com to arrange payment

Email address *
FIRST NAME *
Your answer
LAST NAME *
Your answer
ADDRESS *
Your answer
CITY *
Your answer
PROVINCE *
Your answer
POSTAL CODE *
Your answer
PHONE NUMBER *
Your answer
If you have any special needs, please help us serve you better by listing them here:
Your answer
Please list any dietary allergies or intolerance
Your answer
DATE *
MM
/
DD
/
YYYY
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service