REGISTRATION FORM

Linda Burr and the Integral Yoga Academy of Australasia (IYAA)
Phone: (08) 8294 3426 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:*
2009
Monday
Tuesday
Wednesday
Jan 12th - Mar 2nd
7 weeks - $98
Jan 13th Mar 3rd
8 weeks - $112
none until
further notice
Mar 23rd - May 11th
6 weeks - $84
Mar 24th - May 12th
8 weeks - $112
Jun 1st - Jul 20th
7 weeks - $98
Jun 2nd - Jul 21st
8 weeks - $112
Aug 10th - Sep 28th
8 weeks - $112
Aug 11th - Sep 29th
8 weeks - $112
Oct 19th - Dec 14th
9 weeks - $126
Oct 20th – Dec 15th
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: