1. Please fill out the following form
2. Print it out
3. Send payment to: Susan Mann, 12645 Travilah Road, Potomac, MD   20854

Please indicate the session(s) you would like to attend:

E-mail:
Tuesday Morning Classes w/Susan Mann
	9:30-11am (Level II) April 14 - June 25 11 week session - Cost: $220
Tuesday Evening Classes w/Susan Mann
	6:30-7:45pm (Level I/II) April 14 - June 25 11 week session - Cost: $220
Thursday Morning Classes w/Susan Mann
	8:00-9:25am (Level III) April 14 - June 25 11 week session - Cost: $220
Thursday Morning Classes w/Susan Mann
	9:30-11:00am (Beginners & Level I) April 14 - June 25 11 week session - Cost: $220
$35 will hold your place, remainder due at or before first class. Please note your class on your check.
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Name:
Day Phone:
Address:
Evening Phone:
Age:
Occupation:
Other yoga experience (teacher):
Any physical disabilities or Neck, Back, or Knee injuries:
Types of exercise (walking, weights, kick boxing, etc.):