3LPlace Registration Form for Special Modules and Workshops
Please complete the following registration as thoroughly as possible as it helps us determine goodness of fit and ensures we are meeting the needs of those who join our Specialty Modules. We need everyone regardless of current 3LPlace status to complete this registration form. Some sections (as indicated) may be skipped by current members.

Format:
Please note: programs will be virtual at this time, via ZOOM.

Healthy Relationships:
Begins on Monday, January 25th. Sessions are one-hour, once a week for 8 weeks.
The program costs $400. Details on payment are at the end of the registration form.

*Note on Dates:
The program will run on Presidents Day, February 15th.
Programming ends the week of March 15th.

Questions regarding registration?
Please email Katie Wilson. KWilson@3LPlace.org or call her at 617-909-9515.

Questions regarding Healthy Relationships- Contact Meghan Montgomery at 617-872-4942.

*Form is best completed on a Laptop/Desktop and not a mobile device. You will receive a copy of this form upon completion.

Email address *
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