Online Registration – Dharma Drum Mountain Chicago

Beginner's Meditation Class

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone number*
Email*
Motivation
What's your motivation in learning about meditation?
Meditated Before?
Have you meditated before?
- Yes
- No
Previous Practice:
Please describe when/where:
Practice Regularly?
Do you practice regularly?
- Yes
- No
Food Allergies:
Do you have any food allergies? If so, please briefly describe:
Health Problems:
Do you have any health-related problems? If so, please briefly describe:
Heard about this event:
Where did you hear about about this event?
If you selected "Other" in the drop-down menu above please tell us where you heard about this event:
If you selected "Other" in the drop-down menu above please tell us where you heard about this event:
Donation
The suggested donation is $30 and you can pay online (via PayPal) below. If you prefer to pay cash (or via check) at the event please change the Payment Method and adjust the amount to $0 in the box below (to circumvent the PayPal step).
Payment Method*
Adjust the Total Amount?
Would you like to adjust the suggested amount? If so, please select the "YES" button below and update the amount as you wish. If not, please select "NO" and proceed to the "SUBMIT" button at the very bottom of this page. If you are planning to bring cash (or a check) select "YES", enter $0 as custom amount (to circumvent the PayPal step), and proceed with submitting the form. You can also send in a check by making it payable to "DDMBA Chicago" and addressing it to: DDMBA Chicago c/o Iris Wang; re: "Beginner Meditation Class", 241 Holbrook Dr, Wheeling, IL 60090
- YES
- NO
Total Amount
Please enter a custom amount you would like to donate via PayPal to attend the event. Suggested amount is 30$.
Class

Price:
Total
$0.00
NOTE: After completing your online registration, please check your email for Paypal payment receipt and registration confirmation -- make sure to check your "SPAM" or "JUNK" folder as well, in case any auto-email from "ddmbachicago.org" was delivered there by mistake.
Name
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Beginner's Meditation Class

Donation