Registration for meditation classes

for Meditation 5: Expanding Your Awareness class; $45 for 3 sessions ($40.50 if paid on-line)

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First name:

Last name:

E-mail address:

Address:

City

Zip

Phone/home: (xxx-xxx-xxxx)

Phone/work: (xxx-xxx-xxxx)

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

(Click on Send to complete the registration process)

Class code: (for office use only)

Class starting date: (for office use only)