Registration for classes

for Pranayam and Astral Energy class;
$30 for 1 session (sorry, no discount if paid on-line)

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* required

*First name:

*Last name:

*E-mail address:

*Address:

*City

*Zip

*Phone/home: (xxx-xxx-xxxx)

Phone/work: (optional)

                    Registering only; will pay $30 at first class.
    Payment: On-line by credit card (a secure transaction) $30

(Click on Send to complete the registration process)


for office use only:

Class starting date:

Class code: