Trauma Informed Mindfulness Registration Form

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Please fill out the following form to register for the 8 week online, Trauma Informed Mindfulness Course. Once you have completed this form. Please send in your course fee to hold your spot.

Email *

How did you hear about our Trauma Informed Mindfulness class? *

Social media

Friend

Announcement at another Dharma Homies offering

Other:

Name

Pronouns

How do you identify? (BIPOC, LGBTQIA+, etc)

Have you practiced with T and Devon before? *

Yes

We will meet for 8 Mondays, 5pm- 6:30pm PST (8pm- 9:30pm EST) starting March 18th. The expectation is that you are present for all classes, especially the first class. If you are unable to make one of the classes we request that you be in communication with us ahead of time. Can you agree to this? *

Yes

Is there any information that would be helpful for us to be aware of regarding accessibility? Any needs?

While resources are limited, we are able to offer some BIPOC scholarships. Are you interested in a BIPOC scholarship?

Yes

Maybe

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How would you like to pay for the class?

Venmo (@anthonyTmaes )

Pay Pal (@anthonyTmaes)

Zelle (AnthonyMaes@gmail.com )

Credit Card (Devon will send an invoice if you select this option. It includes a processing fee)

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Any additional questions or concerns you would like to share?

Submit

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