(MBWE : 1-to-1) 8-Week Mindfulness-Based Wellbeing Enhancement

8-Week Mindfulness-Based Wellbeing Enhancement (MBWE : 1-to-1)

8 Week Programme (8 sessions x 2 hours + 1 session x 4 hours = total of 20 hours)
Schedule

Session #1 : 2 hours (weekday mornings or evenings)

Session #2 : 2 hours (weekday mornings or evenings)

Session #3 : 2 hours (weekday mornings or evenings)

Session #4 : 2 hours (weekday mornings or evenings)

Session #5 : 2 hours (weekday mornings or evenings)

Session #6 : 2 hours (weekday mornings or evenings)

Session #6a : 4 hours (choose a day and duration on a weekend)

Session #7 : 2 hours (weekday mornings or evenings)

Session #8 : 2 hours (weekday mornings or evenings)
Note :
- Session #6a is a must to be a 4-hour block.
- Contact numbers will be collected, to communicate, for admin and support purposes.
- Payment needs to be made upon submission of this registration form, to confirm your registration for the programme.
I have read the above, and agree to attend the sessions of the programme accordingly. *

Yes No

Name *

First Name Last Name
How would you like us to address you? *
A name you are comfortable to be addressed by
Year of Birth *
Mailing Address (to mail the training materials to you) *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Email *
example@example.com
Phone Number *

Area Code Phone Number
What questions might you have about mindfulness and/or the 8-Week MBWE programme?

Payment Method

Confirm your registration by making payment of SGD$2,000.00/pax, through the channels stated below.
We appreciate payment as part of completing your registration.

Please, either :

* take a screenshot of the completed transaction and upload the picture of the transaction below

or

* indicate transaction reference number

before submitting this form.
Please state your name, when making payment via :

* PayNow (QR Code)

* PayNow (UEN) : 201405765M

or

* Bank Transfer to:

Bank Name - Maybank Singapore

Swift Code - MBBESGS2

Account Number - 04071076351
Please upload the screenshot of the completed transaction here:
Or, provide the transaction reference number here :

Intake Questionnaire

Please answer the following questions. All information you provide will be kept strictly confidential, and will only be used to support you in achieving the full benefit from your efforts in the Mindfulness programme. There are 8 questions in total.
What is your primary motivation for joining this programme? *
What are your expectations of the programme? *
Do you have any prior experience in meditation/mindfulness? Please describe. *
Do you currently have a meditation practice? If so, how long have you been practicing and how frequently do you practice, and for what duration? *
Do you follow a particular faith tradition? If so, please describe and include whether you perceive there may be any conflict between your faith tradition and the practice of Mindfulness Meditation. *
If you live with someone else, will they be supportive of your efforts to complete the 8-Week Programme. *
On a scale of 1 to 10, how certain do you feel that you can commit to approximately 30 to 45 minutes of practice a day, 5 out of 6 days a week while you are in the programme. Please indicate, “1” being the least certain, “10” being absolutely certain. *
eg. 7
Indicate what you feel will be your biggest hindrance to commit to approximately 30 to 45 minutes of practice a day, 5 out of 6 days a week while you are in the programme. *

8-Week Mindfulness-Based Wellbeing Enhancement (MBWE : 1-to-1)