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:*

2010
Monday
Tuesday
Aug 9th - Sep 27th
8 weeks - $112
Aug 10th – Sep 28th
8 weeks - $112
Oct 18th - Dec 14th
9 weeks - $126
Oct 19th – Dec 14h
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: