Being Nature Bookclub Course Registration Form
Live online programme facilitated by Dr Adele Stewart. Fill out the form carefully for registration. Please feel free to contact Adele on adeledave@me.com.
Name
*
Preferred First Name
Last Name
E-mail
*
example@example.com
Mobile Number
*
Age
Course date
Please Select
Commence 5th Dec 2023
Credit card payment for admin fee. If using mobile phone to register, you may need to click over the text rather than the box.
*
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Being Nature online book club course admin fee
$
25.00
AUD
Being Nature online book club course admin fee (Pensioner/Health care card holder)
$
15.00
AUD
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please select all of the below to acknowledge you are aware of conditions of registration (may need to click on text box):
*
If I haven't received an instant confirmatory email regarding the course I will contact Adele after checking my junk mail.
I'm aware that the above payment is an administration fee.
If I am unable to or decide not to attend the course I will notify Adele ASAP to enable others the opportunity. I will not receive a refund for the admin fee.
I'm aware that the teaching is given on a donation basis to enable all to participate, AND that a donation within my means is expected either before, during or after the course. See website for ways of donating. (Donations subsidise places on other more expensive courses.)
Reason for attending course.
Meditation experience (none required). Please specify.
Zoom experience
Please Select
None
A little
Moderate
Lots
Any other questions or comments.
Submit Application
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