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Please complete registration form. All information is
confidential.
I am registering for the following class location:
Lancaster
- Mondays, October 5th - November 9th (3-4:00PM)
Harrisburg
- Wednesdays, September 23rd - October 28th (7:30-8:30AM)
Rates: $15 per class
Individual Class - $15/class
Register for 6 Classes - $80
EAP Session: 6 classes (You may
use one EAP session for six classes.)
** No refunds for unused classes **
Method of Payment:
- Cash
(bring to class; receipt will be provided)
- Check
(payable to Life Management Associates. Please note in Memo:
Meditation/Class Date)
- Credit
Card (to use your credit card, call LMA office at 394-6688)
- I
will be using PayPal for payment (once you click the submit button at the
end of this form, you will be forwarded to a confirmation page, when you can
select PayPal option)
- EAP (1
EAP Session = 6 classes)
IF YOU ARE USING YOUR LMA EAP TO
ATTEND, PLEASE COMPLETE THE FOLLOWING SECTIONS:
(if not using EAP sessions, click on the submit button at
the bottom of this page)
CHECK ONLY ONE IN EACH CATEGORY:
If you are a family member of an
employee who has Employee Assistance Program (EAP) benefits, complete this
section about the employee:
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