NYIA Ba Gua Intensive 2014 Registration Form

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Program Date: 2014

Location: NYC, NY

To Register: please complete the information below and then click the "Submit" button.

Space is limited to 25 participants.
You will be notified if you are admitted into the seminar.
You will be notified if you are placed on a waiting list should we reach capacity.

First Name *

Last Name *

Email *

Confirm Email *

Phone *

include area code, ex. 801-999-1000

Street address *

City *

State *

Zip *

Are you a NYIA student?

Ba Gua Zhang

Xing Yi Quan

Qi Gong/Nei Gong

Other:

How did you hear about this course?

Email announcement

Website posting

Friend

Other:

Submit

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