Mindful Living

Day of Mindfulness Registration

Name:
Address:
Address 2:
City:
State/Province:
Zip/Postal Code:
Phone- Work:
Phone- Home:
Phone- Cell:
Email:
How did you find out about the Day of Mindfulness?

What brings you to the Day of Mindfulness? In other words, why are you considering it?

Please provide a brief description of your experience with mindfulness meditation. For example, are you a beginner, have you practiced another kind of meditation, have you had formal mindfulness training?

Please select the Day of Mindfulness session you wish to register for:
	Saturday, 2/28/09 Saturday, 5/02/09

Upon completion and submission of the Day of Mindfulness registration form, you will be notified immediately that the form has been received. Later you will receive confirmation of your place at the Day of Mindfulness. If you do not receive either notification, please call 713 522 7032 or email us.