24 Hour Hotline:
803-771-RAPE (Richland and Lexington counties)
1-800-491-RAPE (Newberry county)

Event and Training Registration

First Name: *

Last Name: *

Name of Organization: *

Home or Work Address: *

City: *

State: *

Primary Phone Number: *

Alternate Phone Number:

Email Address: *

Event Training: *

I understand that by filling out the above form and checking “Agree” below I am registering for a training/workshop/event with Sexual Trauma Services of the Midlands on the date that I have indicated. I agree to attend the selected event for the entire duration. I agree that if I am unable to attend the event for which I have registered I will give at least 48 hours notice to Sexual Trauma Services of the Midlands. If a training, I understand that if I fail to give at least 48 hours notice of my cancelation I may be charged for the cost incurred for my absence in the training, even if the training was being held free of charge.
I also acknowledge that I am at least 18 years of age.

Agree: *

I AGREE to the terms and conditions above and will continue with registering for this event.

Completed applications must be submitted online or returned via email, mail or fax to Sexual Trauma Services of the Midlands. Your registration is not complete until you receive a confirmation from the STSM offices indicating that you have been registered.

Fax #: 803-790-8282

Email: stsm@stsm.org

Mail: STSM, 3700 Forest Drive, Suite 350, Columbia, SC 29204

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