To sign up: Please print this page, fill out the following information, and mail it with your check or money order to: HETI 25 Middle Street Portland, ME 04101 Name:  _______________________________________ Telephone number:  _______________________________________ E-mail Address:  _______________________________________ Address:  _______________________________________ City:  _______________________________________ State:  __________ Zip:  __________ I will be attending Motivational Interviewing: The Basics on (please check one): September 22nd and 23rd, 2010:  _____ December 7th and 8th, 2010:  _____ I will be attending Motivational Interviewing:  Advancing the Practice on (please check one): September 24th, 2010:  _____ December 9th, 2010:  _____ Thank you!

Motivational Interviewing: The Basics Plus Motivational Interviewing:  Advancing the Practice Discounted Rate! Both trainings for $215.00. Taught by Stephen Andrew, LCSW, LADC, CCS