World Dharma Mindful Intelligence Transformation Training Retreat Canada  2017

Online Request To Attend – Application Form
Wisdom of Mindfulness April 13 – 17, 2017
Please fill out all fields and we will confirm your space shortly

MaleFemale

Full Name (First, Middle, Last)

Address

City

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How did you learn about the retreat?

Private roomShared Room

VegetarianFish & Fowl

Please explain in a sentence or two why you wish to attend the retreat.

How will you pay for the retreat? Pay Pal? Credit Card? Check? Other?

Upon acceptance to attend the retreat a $195 deposit must be made, with full payment
by March 1​, 2017​ (40 days before the start of the retreat), unless otherwise agreed.

​Thank you.​
Namaste.