Registration for Open Heart Workshops Levels 5 & 6 September 15-16, 2018
Please complete the following. Thank you! If you are a repeater, please just use N/A for redundant fields. We do need your name and repeater status however!!
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. For repeater- put N/A
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
Check the workshops you are registering for below *
If this is your first time attending an Open Heart Workshop, you may sign up for Levels 5 & 6 (Level 5 is pre-req for Level 6). Please contact coordinator for senior and student or other discounts or issues.
New $225
Senior (62+) Discount $168.75
Repeat $75
Not attending Level 5
Open Heart Level 5
Check the workshops you are registering for below *
If this is your first time attending an Open Heart Workshop, you may sign up for Levels 5 & 6 (Level 5 is pre-req for Level 4). Please contact coordinator for senior and student or other discounts or issues.
New $250
Senior (62+) Discount $187.50
Repeat $85
Not attending Level 6
Open Heart Level 6
Please send deposit of $50 per workshop ($100 for both), MADE PAYABLE TO "Open Heart," to workshop coordinator, Rana Jackson 144 Sienna Rd Saluda, NC 28773
Deposits secure your space in the workshop.
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