SMART Recovery Training Registration WARNING: This form uses Javascript. You appear to have Javascript disabled in your browser, which will disable some form functionality and may cause it to perform unpredictably. * marks required items TRAINING OFFERINGS Select one:' GSF 200: Meeting Host Training -- $39.00GSF 201: Facilitator Training -- $99.00GSF 202: Family & Friends Training -- $40.00GSF 203: Facilitator and Family & Friends Training Package -- $129.00GSF 301: SMART Recovery for Professionals -- $299.00OST: Onsite Training Your Facilitator Training Completion Date * [?] Registering two participants? Click to save $ Please enter one participant's information below, then pay the discounted $ price for two registrations. After registering, you will go to a second page to register the second participant. INSERT MESSAGE HERE Training ID * Please note: Onsite Trainings are prescheduled trainings at a specific location. PARTICIPANT INFORMATION First name * Last name * Primary Email * Secondary Email (optional) Phone * Address * City * Country * Select a Country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua And Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia, Plurinational State Of Bonaire, Sint Eustatius And Saba Bosnia And Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Canada Cambodia Cameroon Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic Of The Cook Islands Costa Rica Cote D'ivoire Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-bissau Guyana Haiti Heard Island And Mcdonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle Of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic Of Korea, Republic Of Kosovo Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia, The Former Yugoslav Republic Of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States Of Moldova, Republic Of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Barthelemy Saint Helena, Ascension And Tristan Da Cunha Saint Kitts And Nevis Saint Lucia Saint Martin (french Part) Saint Pierre And Miquelon Saint Vincent And The Grenadines Samoa San Marino Sao Tome And Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch Part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia And The South Sandwich Islands South Sudan Spain Sri Lanka Sudan Suriname Svalbard And Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic Of Thailand Timor-leste Togo Tokelau Tonga Trinidad And Tobago Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela, Bolivarian Republic Of Viet Nam Virgin Islands, British Virgin Islands, U.S. Wallis And Futuna Western Sahara Yemen Zambia Zimbabwe State/Province * Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Select a Province Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan Northwest Territories Nunavut Yukon 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 * Education * Please select... Less than high school High school/GED Some college 2-year college (Associates Degree) 4-year college (Bachelors Degree) Masters degree Doctoral degree Professional degree Are you a Treatment Professional? * Yes No Your Credentials / Title * Your Organization * Please choose the option(s) that best describe why you are completing the training: I am starting a new meeting I am planning to assist with an existing meeting I am 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 Explain * YOUR SMART MEETING In order to register for free host training, you must be working with the facilitator of an existing SMART meeting. Please provide the facilitator and meeting name for verification. Your local SMART meeting * SMART meeting facilitator's name * BILLING DETAILS Same as above First name * Last name * Company * Bill to company name Email * Phone * Address * City * State/Province * Postal code * Country * Select a Country'; Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua And Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia, Plurinational State Of Bonaire, Sint Eustatius And Saba Bosnia And Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Canada Cambodia Cameroon Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic Of The Cook Islands Costa Rica Cote D'ivoire Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-bissau Guyana Haiti Heard Island And Mcdonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle Of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic Of Korea, Republic Of Kosovo Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia, The Former Yugoslav Republic Of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States Of Moldova, Republic Of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Barthelemy Saint Helena, Ascension And Tristan Da Cunha Saint Kitts And Nevis Saint Lucia Saint Martin (french Part) Saint Pierre And Miquelon Saint Vincent And The Grenadines Samoa San Marino Sao Tome And Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch Part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia And The South Sandwich Islands South Sudan Spain Sri Lanka Sudan Suriname Svalbard And Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic Of Thailand Timor-leste Togo Tokelau Tonga Trinidad And Tobago Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela, Bolivarian Republic Of Viet Nam Virgin Islands, British Virgin Islands, U.S. Wallis And Futuna Western Sahara Yemen Zambia Zimbabwe PAYMENT Promo Code? Credit Card * Expiration * CVV * Routing #* Account #* Your promo code means your course will have no cost to you, so no credit card information is required. I acknowledge my registration fee is non-refundable* I accept the Terms of Service (read here)* REGISTER