Registration
  - Required field
 PLEASE PROVIDE YOUR PERSONAL INFORMATION: 
First Name  
Last Name  
Gender Female
Male
 
Birth Date   Click Here to Pick up the date
Address  
City  
State/Province  
Zip Code  
Home Phone
Cell PHone
Email  
Date Basic Pranic Healing Taken   Click Here to Pick up the date  
Location  
Instructor  
 CONFIDENTIAL STUDENT DATA (PLEASE ANSWER ALL QUESTIONS): 
Do you smoke? Yes
No
 
Do you take drugs? Yes
No
 
Do you drink alcoholic beverages? Yes
No
 
What is your diet? Vegeterian
Non-Vegeterian
 
Do you have history or present serious physical or sychological disorders? Yes
No
 
If yes, please explain
Have you been diagnosed or had history of contagious diseases or other illnesses Yes
No
 
If yes, please explain
 WORKSHOP INFORMATION:
 

       EARLY BIRD 

 AT THE DOOR

 

 AMOUNT DUE
 

 by June 1

 by July 1

  
Arhatic Yoga Preparatory Level - NEW
Arhatic Yoga Preparatory Level - REVIEW
No, thank you

$ 595.00
 $ 175.00
$0.00

 $ 630.00
 $ 210.00
$0.00

$ 700.00
 $ 250.00
$0.00

$ 
Buddhism Revealed - NEW
Buddhism Revealed - REVIEW
No, thank you

$ 395.00
 $ 125.00
$0.00

 $ 450.00
 $ 150.00
$0.00

$ 500.00
 $ 175.00
$0.00

$ 
AY Prep Level & Buddhism Revealed - NEW
AY Prep Level & Buddhism Revealed - REVIEW
No, thank you

$ 895.00
 $ 265.00
$0.00

 $ 960.00
 $ 310.00
$0.00

$ 1095.00
 $ 375.00
$0.00

$ 

 WORKSHOP TOTAL:

$ 

 

 I would like to purchase the Ashram package*
  Yes
No
 

$ 175.00
Friday and Saturday night stay, Friday night, Saturday and Sunday meals

  
 I would like to purchase meals**
  Yes
No
 

 $95.00
Friday dinner
 Sat & Sun lunch & dinner

 $55.00
Friday dinner
Saturday lunch & dinner

 $80.00
Saturday & Sunday
lunch & dinner

  
 I need transportation to and From Bovina**
  Yes
No
 

 $60.00

      
 I need transportation from Newark Airport to the CPH
Yes
No
 
If yes, please provide flightt information below

 Free
Friday

  

 Free

  

 FOOD, ACCOMODATION & TRANSPORTATION TOTAL:

 $

 TOTAL AMOUNT DUE:

$

AIR TRAVEL:
Transportation will only be provided from Newark (EWR) airport to the Center for Pranic Healing on Friday, July 18th. Plan to arrive no later than 1:00pm as the MCKS Arhatic Yoga Meditation Center is 3 hours away. The bus will leave from the Center for Pranic Healing at 2:00pm on Friday, July 18th. The Center for Pranic Healing and volunteers will not provide transportation outside of these recommended arrivals and departure times.
 
TRANSPORTATION TO AND FROM THE MCKS ARHATIC YOGA MEDITATION CENTER:
A bus will be leaving the Center for Pranic Healing on Friday, July 18th at 2pm. It will leave the MCKS Arhatic Yoga Meditation Center on Sunday, July 20th at 9pm. The bus will be stopping at The Center for Pranic Healing, then at the Holiday Inn by Newark Airport and finally in New York City by the Port Authority Bus Terminal on 42nd Street and 8th Avenue. 
   
 FLIGHT INFORMATION:  
 
 Arrival Information             
 Airline:    Flight No:    Airport  

 Arrival Date:

    Click Here to Pick up the date  Arrival Time:  
Departure Information              
 Airlline:    Flight No:    Airport:    Departure Date:    Click Here to Pick up the date  Departure Time:  
 LODGING INFORMATION:  
 
 I have made reservations to stay at:  

On the following nights:

  Thursday, 7/17  Friday, 7/18  Saturday, 7/19  Sunday, 7/20
 If you are staying at the Ashram's Chakra House, please list anyone you would like to share a bed with:   
  
 PAYMENT INFORMATION FOR MCKS WORKSHOPS:  
 
  Select Payment Option:

 Select Credit Card Type:  
   Credit Card Number:
   Please call Center if paying by card 		 Exp. Date:   
IMPORTANT NOTICE FOR PAYMENT PLAN ARRANGEMENTS:  The ‘at the door’ price will apply for all Payment Plans.  Payment of 30% of the Workshop total amount due plus 100% of the Food, Accommodation and Transportation total amount due must be received before the start of the workshop.   Check Amount:   Check Number:
 Cash Amount:
If payment plan option is taken, please provide the amount to be taken monthly from credit card indicated above or the monthly amount to be sent by check.