Ming Mindfulness MBCT-L course registration
Event Timing: From 28 Aug 22 to 16 Oct 22, Every Sunday 8.30am to 10.45am
+ Full day silent retreat on 7 Oct 22 [Friday 9.15am to 4.45pm]
Event Address: SCWO @ 96 Waterloo Street
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Full name (To be shown on certificate) *
Email *
Contact number *
Gender *
Age *
Occupation / Designation *
Emergency contact - Name *
Emergency contact - Relationship *
Emergency contact - Number *
Do you have any limitation on your physical mobility that might make sitting, standing, walking or physical activities difficult for you? If yes, please elaborate. *
Are there any present circumstances which might be placing you under exceptional stress, such as depression, anxiety, stressful life changes (e.g. bereavement, loss of home, job etc.)? If yes, please elaborate. *
Are you currently receiving any form of treatment (e.g. psychological or medical treatment)? If yes, please elaborate. *
Why do you want to attend the programme (e.g. physical health, mental wellness, stress, self-development etc.)? What do you hope to gain from the programme? *
Which media channel did you find out about this workshop? (E.g. Word of mouth Referral, FB, Instagram etc. If by referral, please indicate name of referee.) *
I understand that the registration for the course will only be confirmed after notification from Ming Mindfulness and on payment of the course fees. *
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