Would you like to attend a workshop in your hometown?
Yes     No

Would you like to host a workshop in your hometown?
Yes     No

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

If so, please provide us with the following information:

Name

Telephone # and area code

Email address

Address

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

Facility Name

Facility Telephone #

Facility Address

Would you like to hold the event in your house?
Yes     No

If so, please answer the following questions.

Is your house large enough to hold 15 participants comfortably sitting in a half circle on chairs?
Yes     No

Is your house quiet and free of telephone and other noise?
Yes     No

Is the space clean and smoke free?
Yes     No

Do you have fragrant candles or other toxic products?

Yes     No

Do you have any pets?    (Some people are allergic to animals)
Yes     No

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

Any comment?

Thank you for your time!