|| plan {A} holistic life™ || Group Meditation: Session Booking Form for Alicia Mathlin
> Please complete all questions to the best of your ability.
> Your privacy means a great deal to me. All information gathered from this form is confidential.
Group Name {skip if not applicable}:
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Primary Contact Name {First + Last}: *
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Primary Contact Telephone Number: *
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Primary Contact Email Address: *
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Location {Toronto only}:
street number, street, city, province, postal code
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Proposed date of session: *
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Proposed time of session: *
Time
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How many participants? {women only} *
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Please select a theme for your group's session with me: *
Tell me a bit about your group: *
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Are you interested in multiple sessions for your group? *
What method of payment will you be using? {instructions will be sent to you accordingly} *
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