Class Registration Form

Class Registration Form

Fill out the form carefully for registration
Student Name

First Name Last Name Student #
Birth Date

Month Day Year
Gender
Address

Street Address

City

Postal / Zip Code Postal Code

Country
Student E-mail
example@example.com
Phone Number
Class
Attendance
Additional Comments
Select your Payment
Fee: $230
E-transfer: alex@aromansse.com
Send Cheque at 359 Home Street, Winnipeg, MB, R3G 1X5
Cash at the physical store or at Meditation Studio
Credit Card: You will receive a link. 3% fee added.
Signature

Clear
Should be Empty: