(Home Page)                                 Registration Form

MAKE CHECKS PAYABLE TO:  MARILYN ALLYSUM

Mail to: 

Tilopa Tai Chi Qigong Center

since 1977

2751 Hennepin Ave S  Suite 292

www.iTaiChi.com

Minneapolis,  Minnesota 55408-1002

612-825-6824

Name: __________________________________________________

Address: ________________________________________________
City: _____________________________  State: _________  ZIP: __________

Home Phone: __________________    Work Phone: _____________________
Email: _______________________________  Cell: _____________________

ENTER THE APPROPRIATE CLASS TUITION PAYMENT BELOW:

GRAND LONG FORM TAI CHI CHUAN & QIGONG, Level 1 Beginner:
  ____ FALL Quarter   Monday Evenings    6:30 - 8:00 PM
          Payment Enclosed:   $ _______ Quarter 1 (DVD sold separately)

LONGEVITY  TAI CHI  &  QIGONG, Beginner Level:
   (Check class time below.)
  ____ Saturday Mornings,  9:00 - 10:00 AM
  ____ Tuesday Mornings,   9:00 - 10:00 AM
          Payment Enclosed:   $ _______ (DVD included)

INTERNAL SYSTEMS Qigong:
           Payment Enclosed:   $  ______

Qigong FOR CANCER: 
          Payment Enclosed:   $  ______

Qigong FOR FERTILITY: 
          Payment Enclosed:   $  ______

Temple Qigong:
          Payment Enclosed:   $  ______

Qigong WORKSHOP:
           Payment Enclosed:   $  ______

OUTREACH PROGRAMS:
Site Location: ________________________________________

Date of Class: _______________________    Payment Enclosed: $________

Classes are not pro-rated. No Refunds.
Locations:
Monday, Thursday, & Saturday classes:
Tilopa Tai Chi Qigong Center
Lynnhurst Church
4501 Colfax Av. S, Minneapolis, Minnesota
Enter on Colfax Av (South Wing)		 Tuesday Morning class:
 Minikahda Club
3205 Excelsior Blvd.
Minneapolis, Minnesota

How did you hear of us? ___________________________________________________