Mindfulness Practice Group for Educators Registration - Acupuncture, Massage, Mindfulness, Traditional Chinese Medicine: Victoria

Mindfulness Practice Group for Educators – Registration Form

Welcome to the Mindfulness Practice Group for Educators! Thank you for your time in completing this form so that I can provide a supportive learning experience. All information shared here will be completely confidential and will only be read by me (Stephanie Curran).

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Name*

First Last

Email*

Cell number*

City*

School*

Position*

How did you hear about this course? (please be as specific as possible)*

Have you practiced mindfulness before?*

Yes

If you answered yes above, please list the teachers you have studied with and what programming or retreats you have completed.

Are you currently experiencing any significant life changes or stressors (ie ending of a relationship, death of a loved one, medical challenges, etc)?*

Yes

If you answered yes above, please share a few words. All details will be fully confidential. It is helpful as the facilitator to know what experiences are present in the group as this will help inform the general guidance I provide during our practice gatherings.

Do you have any questions or comments?

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Today's Date

Mindfulness Practice Group for Educators

Price:

GST

$ 0.00 CAD

Total

Payment Method

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