REGISTRATION FORM

Linda Burr and the Integral Yoga Academy of Australasia (IYAA)
Phone: (08) 8296 4585 or Mobile: 0431 300 151
lindaleila@iprimus.com.au
Contact Information
First Name*
 		Last Name*
Address*
  
City*
 State*
Post Code*
Phone*
Email*

Please choose which class you would like to attend:*
2012
Monday
Tuesday
Jan 9th - Feb 27th
8 weeks - $112
Jan 10th - Feb 28th
8 weeks - $112
March 19th - May 7th
7 weeks - $98
March 20th - May 8th
8 weeks - $112
May 28th - July 16th
7 weeks - $98
May 29th - July 17th
8 weeks - $112
Aug 6th - Sept 24th
8 weeks - $112
Aug 7th - Sept 25th
8 weeks - $112
Oct 15th - Dec 10th
9 weeks - $126
Oct 16th - Dec 11th
9 weeks - $126
TIME: All classes run from 6:15 pm to 7:45 pm
LOCATION: 310 South Terrace Adelaide - free parking is available

Payment Options*

Direct Deposit
Account Name Linda Burr
Bank Savings & Loans Credit Union
BSB Number 805 023
Account Number 02345012
Reference YOUR SURNAME

Please bring your copy of registration form and online payment receipt with you.

Cheque or Money Order
Linda Burr
PO Box 22
Glenelg 5045 South Australia.

If paying by post include a self-addressed envelope for your receipt to be posted out otherwise receipts can be collected on the first night.

Please advise if there are any health problems we need to know about:

Comments or Questions:


Last Updated December 18, 2011