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Introduction to Mindfulness (MBSR) Course Registration Form

_{Payment plans available. Limited need-based support available by contacting the Center. Mail-in registration forms also available.}

Contact Information

Name

First Name

Last Name

Verify Email

Phone

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Do you need the course text?

The course text is "Full Catastrophe Living " by Jon Kabat-Zinn

Yes, please provide me with the book.

No, I have (or will obtain) my own copy of the book.

Payment Options

$350 - Full Course Fee (includes book)

$335 - Full Course Fee (no book)

$175 - Payment Plan (2 payments, one month apart)

$87.50 - Payment Plan (4 payments, spread over 4 months)

Payment Plan Schedule

If other, please specify

Is there someone we can thank for referring you?

Add 3% to my total amount to help cover the payment processing fees