Registration for Open Heart Workshops Levels 3 & 4 September 16-17th, 2017
Please complete the following. Thank you!
Name First, Last *
Your answer
Name as you wish it to appear on Certificate
(If different from above)
Your answer
Address *
Please be sure to include city and state
Your answer
Email Address *
This will only be used to communicate about the workshops and will not be shared.
Your answer
Age
Your answer
Phone number(s) *
used only for communication about this workshop
Your answer
Occupation
(Please specify if Clergy, Full-time Student, Senior/Retired, Child, or your profession)
Your answer
PREVIOUS MEDITATION EXPERIENCE:
(not necessary)
Your answer
How did you hear about this workshop?
Your answer
If you are repeating, please list date of workshop and instructor below
Your answer
Check the workshops you are registering for below *
Scholarships are available, please contact coordinator for details.
New $175
Senior (62+) Discount $131
Full Time Student Discount $131.25
Repeat $65
Not Taking Level 3
Open Heart Level 3
Check the workshops you are registering for below *
New $200
Senior (62+) Discount $150
Full Time Student Discount $150
Repeat $70
Not taking Level 4
Open Heart Level 4
Please send deposit of $50, MADE PAYABLE TO "Open Heart," to workshop coordinator, Rana Jackson 144 Sienna Pl Saluda, NC 28773
Deposits secure your space in the workshop.
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