Learn to Meditate Course Registration - Other Form of Payment – Thom Knoles

NAME*

EMAIL*

PHONE NUMBER

DATE OF BIRTH*

WHAT'S YOUR OCCUPATION?*

Have you attended an Introductory Talk?*

WHICH INTRO TALK DID YOU ATTEND?*

Can you attend all 4 days of the course?*

ARE YOU UNDER REGULAR CARE OF A MEDICAL PRACTITIONER?*

ARE YOU TAKING ANY PRESCRIBED MEDICATION?*

Untitled*

Do you have any additional comments or questions for us today?

VEDIC MEDITATION COURSE REGISTRATION