Mindfulness Based Programs Sign Up Form

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Please let us know which program(s) you're interested in and your availability:

Email *

First and Last Name *

Today's Date *

YYYY

Which Mindfulness Based Program(s) are you interested in? *

Mindfulness Based Stress Reduction (MBSR)

Mindfulness Based Cognitive Training (MBCT)

Mindful Self-Compassion (MSC)

Mindfulness Based Relapse Prevention (MBRP)

iRest Yoga Nidra (iRest)

Unified Mindfulness (UM)

Mindful Communication

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Please indicate your availability (select all that might work for you): *

10 am - noon

1 pm - 5 pm

5 pm - 9 pm

Not Available

Other*

Saturdays

Sundays

Mondays

Tuesdays

Wednesdays

Thursdays

Fridays

*If you selected "other" in the above chart, please describe here:

Anything else you would like us to know?

Thank you - we will contact you when we have sufficient interest in a given program.

If you have any questions, please email us at info@mindfulness-alliance.org

A copy of your responses will be emailed to the address you provided.

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