SUBSTANCE ABUSE SUBTLE SCREENING INVENTORY (SASSI)
TRAINING WORKSHOP

To register, complete the following form and return with your payment

SASSI Training Workshop Enrollment Form

Name:

Occupation:

Agency:

Mailing Address:

City: State: ZIP:

Phone Number:

Confirm Phone Number:

Email Address:

Confirm Email Address:

Method of Payment:



Select a Payment Amount and Class Type:

 

Please make Checks or Money Orders payable to Terry L. Stover and return to:

Terry L. Stover
4706 S. 199th E. Ave.
Broken Arrow, OK 74014
Cell Number: (918) 857-1955 (local in Tulsa )
Fax: (918) 355-5703

All cancellations must be made via phone or e-mail 48 hours before the training for a refund.