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* 1. Name:

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* 2. Email: (We will use your email only to contact you about this pilot program and any additional opportunities specifically related to On Pause: Mindfulness at the Wex.  Your information will not be added to Wexner Center lists for other programs.)

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* 3. Briefly describe your current level of experience with mindfulness and your experience being in either galleries or art museums.

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* 4. Briefly describe why you are interested in participating in this program.

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* 5. How did you hear about this program?

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* 6. Which sessions will you be attending?  Mark all that apply. 

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