Mindfulness-Based Stress Reduction Course Registration Please complete this Registration form: Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* How did you hear about us?*Select OneSearch Engine/AMI WebsiteSocial MediaPast Participant RecommendationAdvertisingOtherHow should we contact you?*EmailPhoneCourse Start Date & Location*Select OneJanuary 28, 2019 - DecaturMarch 25, 2019 - DecaturMindfulness-Based Stress Reduction Course Fee Price: $550.00 Terms & Conditions: No refunds once class starts. Full refund up until 14 days before course begins (minus 25.00 processing fee). If you cancel after the 14 days but before class, there is a $100.00 fee.* Yes, I agree to the Terms & Conditions Total $0.00 Once AMI receives course payment, participant will receive an email that includes a password to class resources. There will be three documents that the participant will need to download and return to AMI prior to the first class
