Yoga Information Form

1. Default Section

Yoga instruction will be tailored to fit each client's individual needs and goals. Be creative in asking for what you want, and we'll work to make it happen!

1. Please provide your contact informaion.

Please provide your contact informaion. Name:
Company:
Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Email Address:
Phone Number:

2. What questions or comments do you have?

What questions or comments do you have?

3. What kind of yoga instruction interests you?

What kind of yoga instruction interests you? Private

Group

Family

Couples

Business (on-site)

Other (please specify)

4. How many sessions would you like to schedule? (We will work out final scheduling details over the phone or e-mail.)

How many sessions would you like to schedule? (We will work out final scheduling details over the phone or e-mail.) Single Session (1 Hour $50.00)

Single Session (2 Hours $90.00)

4 1-Hour Sessions ($160.00)

4 2-Hour Sessions ($280.00)

Not sure yet

5. Please indicate what days and times are convenient for you to schedule sessions.

	Morning	Afternoon	Evening
Monday	Please indicate what days and times are convenient for you to schedule sessions. Monday Morning	Afternoon	Evening
Tuesday	Tuesday Morning	Afternoon	Evening
Wednesday	Wednesday Morning	Afternoon	Evening
Thursday	Thursday Morning	Afternoon	Evening
Friday	Friday Morning	Afternoon	Evening
Saturday	Saturday Morning	Afternoon	Evening
Sunday	Sunday Morning	Afternoon	Evening

6. Any special requests?

Any special requests?

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