CMI-APP-NEW-NOV2016

Title (select from this list)

Name:

Email:

Short name - Nickname - How you like to be addressed (if applicable)

Street Address 1

Street Address 2

City - Town

US State (if applicable)

State - Province (if outside the USA)

Zip - Postal Code

Country

Educational Background (brief overview)

Past Meditation Experience or Training (if applicable)

Hobbies - Interests

Please read and click each of the four boxes below to agree

I understand that I must pass all components of the C.MI program to receive a certificate

I understand that I am responsible for purchasing the required course texts

I understand that my tuition is due in full - or my installment plan set-up - prior to starting the course

I have read and agree to the Terms and Conditions of this course

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