MBSR Registration
MBSR Registration
Name
Name
*
First
Last
Email
*
Phone
Phone
*
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Emergency Contact Name & Number
Emergency Contact Name & Number
*
First
Last
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Classification
*
Classification
Undergraduate student
Graduate student
Staff
Faculty
Public
I am interested in
*
I am interested in
Fall MBSR (Waiting list)
Winter MBSR (beginning January 23, 2019)
Futures sessions
What are your expectations/hopes for this class?
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Is there anything else that would be helpful for the instructor to know about you?
I am a student interested in receiving information about scholarship opportunities for financial assistance.