Full name: • e-mail: • Contact Phone: • Locality: Morning Session: SELECT 2012 MORNING SESSION THU. 12 JAN THU 16 FEB THU MAR THU. APR THU MAY THU JUNE THU JULY ] THU AUGUST THU SEPTEMBER Evening Session: SELECT 2012 EVENING SESSION TUE 17 JAN TUE 21 FEB TUE 20 MAR TUE 17 APR TUE 22 MAY TUE 19 JUNE TUE 24 JULY TUE 21 AUGUST TUE 25 SEPTEMBER TUE 23 OCTOBER TUE 20 NOVEMBER TUE 11 DECEMBER Meditation Course: MEDITATION COURSE DATE > SUNDAY 30 OCTOBER 2011 Referral: SELECT WHERE YOU HEARD > FESTIVAL OR EXPO PUBLICATION BROCHURE PROMOTIONAL FLYER PRACTITIONER GOOGLE WEBSITE YELLOW PAGES WORD OF MOUTH A FRIEND OTHER REFERRAL Source of Referral: Any Meditation Experience? yes no