Registration for meditation classes

for Meditation 1 class; $45 for 3 sessions ($40.50 if paid on-line)

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* required

* Class starting date: (MM/DD/YY)

* First name:

* Last name:

* E-mail address:

* Address:

* City

* Zip

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

Phone/work: (xxx-xxx-xxxx) (optional)

Payment: On-line by credit card (a secure transaction)
Registering only (pay at first class)

(Click on Send to complete the registration process)


For office use only

Class code: