TIM Supervisors' Studio Registration Interest Form

Registration Interest Form

Please fill out this form to indicate your interest in registering for Together in the Mystery's Supervisors' Studio, a community of spiritual direction supervisors that offers monthly consultation, an ongoing forum for discussion, and other benefits.
Just A Note

Filling out this form is the first step in the process of registration, which will included confidential verification of being in spiritual direction and supervision yourself, as well as a monthly or annual fee. Please know you are under no obligation in this process, and your responses will be stored in a HIPPA-compliant datebase. We look forward to journeying with you.
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
I am a practicing... (choose all that apply)

Spiritual DirectorSpiritual Director SupervisorSupervisor of Student Spiritual DirectorsSupervisor of Student Supervisors
I received my spiritual direction training at:
I received my supervision training at:
I am in on-going spiritual direction with my own spiritual director.

YesNo
I am in on-going supervision with: (choose all that apply)

An individual supervisorA supervisor-facilitated peer groupA peer-facilitated supervision groupI am not currently in supervision
I am interested in the following level of payment for the TIM Supervisors' Studio:

Monthly US-rate: $10/monthYearly US-rate: $96/yearMonthly International-rate: US$8/monthYearly International-rate: US$72/year
Signature

Clear
Should be Empty:

Registration Interest Form

Just A Note