Would you like to attend a workshop in your hometown?
yesno

Would you like to host a workshop in your hometown?
yesno

(A 15-person minimum is required to hold a workshop)

If so, please provide us with the following information:

Your Name (required)

Home Phone

Your Email (required)

Address

City

State

Country

Zip Code

If different from where you live, where you would like to hold the event?

Facility Name

Facility Telephone Number

Facility Address

City

State

Country

Zip Code

Would you like to hold the event in your house?

YesNo

If so, please answer the following questions.

Is your house large enough to hold 15 participants comfortably sitting in a half circle on chairs?
YesNo

Is your house quiet and free of telephone and other noise?
YesNo

Is the space clean and smoke free?
YesNo

Do you have fragrant candles or other toxic products?
YesNo

Do you have any pets? (Some people are allergic to animals)
YesNo

If so, what kind of pets and how many do you have?

Any comment?

Thank you for your time.

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