Positioned for Mindfulness                        
Registration and Payment Information: After you fill out this form, we will confirm your registration and payment with a receipt or process the necessary information to enroll you in the ACH monthly withdrawal plan. Be sure to look for your email and review the information and agreements for this program. If you would like faster service and direct information on current pricing please Contact us at (810) 241-5234 or roberta@RobertaCoCco.com
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Are you an existing client?
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What Positioned for Mindfulness Class are you  registering for? *
Do you have any medical or health issue that would prevent you from participating in this class? *
Where did you hear about this opportunity? *
Contact info
Your name *
E-mail  * All Information, agreements and reminders will be sent to this account. Be sure to monitor your spam folders *
Phone number
The course price is $597
How will you be purchasing this course? *
For ACH withdrawals please fill out the following information
Name of Bank/Financial Institution
Type of Bank Account
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Account type
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Routing Number
Account Number
By checking the box below you agree to give Roberta Cocco LLC permission to collect ACH electronic payments through the noted financial institution and account provided. Payments in the amount of $199 will be withdrawn on the fifteenth of March, April and May   2021, for a total amount of $597
I have read and agree to the Terms and Conditions of this class as outlined here: https://www.robertacocco.com/termsandconditions *
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