Yoga In Bali — Asia Students Registration Form
Please choose which program for enrollment:
Program # 1
9 Day / 8 Night Package: Saturday, 20 November - Sunday, 28 November, 2010 (16 classes)
Option A.) - Yoga classes fees only (students arrange their own Ubud accommodations) = $600.00USD
Option B.) - Yoga classes and 8 nights shared Ubud accommodations at
studio accommodations = $900.00USD.
Program #2
5 Day / 4 Night Package: Saturday, 20 November - Wednesday, 24 November, 2010 (8 classes)
Option A.) - Yoga classes fees only (students arrange their own Ubud accommodations) = $300.00USD
Option B.) - Yoga classes and 4 nights shared Ubud accommodations at
studio accommodations = $450.00USD
Program #3
5 Day / 4 Night Package: Wednesday, 24 November - Saturday, 28 November, 2010 (8 classes)
Option A.) - Yoga classes fees only (students arrange their own Ubud accommodations) = $300.00USD
Option B.) - Yoga classes and 4 nights shared Ubud accommodations at studio accommodations = $450.00USD
Enclosed Enrollment Fees for: Full payment due by October 30, 2010
Program #1 = 20 - 28 November(9D / 8N)________Option A $600.00
_______ Option B $900.00
Program #2 = 20 - 24 November (5D / 4N)________Option A $300.00
_______ Option B $450.00
Program #3 = 24 - 28 November (5D / 4N)________Option A $300.00
________Option B $450.00
Name __________________________________________________
Address _______________________________________________
Home phone ____________________________________________
Business Phone ________________________________________
Email Address ________________________________________
Date of Birth _________________________________________
Special Interest ______________________________________
For International students, please provide full payment via bank transfer to:
Bank of America
41st & Capitola- 4055 Capitola Rd.- Capitola, Ca. 95010 USA
Swift # BofA US3N
Routing # 026009593
Name on Account: Ann Barros
Account # 06705-02286
email Ann at abarros@pacbell.net