Dharma Path Registration FOR Level 1

Dharma Path Level 1 Registration
The registration fee is $150 to cover administrative costs.
Your Name*

PrefixFirst NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Telephone*

Area CodePhone Number
If you would like to request a specific mentor, please specify:
How did you hear about the Dharma Path program?
Donation Amount
prevnext( X )
Dharma Path Level 1$150.00

Total $0.00
If you have previous training in meditation and/or Buddhist studies, please describe it.
What is your current practice?
YesNo
I understand that I am undertaking a course of daily meditation requiring that I keep an accurate record of my practice hours.
I understand that by e-signing below, this represents me and is equivalent to my physical signature.
Signature*

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Security Verification*

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.