The Breema Center: Instructor Class Information Form

We are actively promoting Breema Bodywork through sales of the book, radio programs, and print media. As part of this ongoing Breema promotion, we want to provide the most accurate and up-to-date information about your classes on the Breema website and when people call the Center to ask about Breema in their area.

This form was created to help us gather class details from all instructors so that it is organized in the same way and provides all the pieces of information needed. Using this form to let us know about your classes helps us help you - and also helps promote Breema around the world!

Title of class:

Type of class (for example, Self-Breema, Breema Bodywork,
Introduction, Free Demo, or etc.) :

Level (for example, Level 1, Adv., Multi-Level, or etc):

Day (for example, Tues eves, Thurs am, or Fri-Sun):

Date (or start date, if recurring weekly):

Frequency or Length (for example, Wknd Workshop,
6-Week Class, Ongoing from Sept. to May, or etc.):

Start & Finish Time (for example, 10am - 5pm):

Other Time Details (for example, I hour lunch break):

Cost:

Payment Details or Discounts, if any:

Name(s) of Instructor(s):

Instructor's Phone #:

Place (for example YMCA, Yoga Center, or etc.):

General Metropolitan or Geographic Area
(especially if actual city name may not be well known.
For example, SF Bay Area, Vancouver Area, Long Island, or etc.):

Street Address (ok to say "Call for Details"):

City:

State or Province:

Country:

Location or Registration Contact (if other than Instructor):

Name:

Phone #:

Other Registration Details:

ADDITIONAL DETAILS
(if applicable):