Register - Dorje Chang Institute

I would like to register* for Mind and Its Potential, Discovering Buddhism, Module 1

*Please fill out one form for each person who wishes to attend this course. Everyone is welcome.

Mind and Its Potential

Discovering Buddhism Module 1

with Simon Harrison, FPMT Registered Teacher

4 Sessions (30 August - 20 September)
1 Retreat Day (27 September, 10am - 4pm)

Course Costs:

General:
Facility Contribution (4 sessions $40 + 1 Retreat Day including Vegetarian Lunch and Afternoon Tea $80) $120
Materials Fee $20
Total: $140

Dharma Friend Monthly Contributors:
Facility Contribution (4 sessions free + 1 Retreat Day including Vegetarian Lunch and
Afternoon Tea $65) $65
Materials Fee $20
Total: $85

We have limited scholarships available for those experiencing financial hardship. These scholarships do request recipients to make a contribution of volunteer work. Please contact our office directly to apply.

For those unable to attend in person, an audio recording service option is available. Same registration process; when you register please note in the comments box of the registration form that you are unable to attend in person and would like the audio recordings. If not attending the retreat in person, only through audio recordings, then we welcome you to contact the office regarding a reduced retreat fee (as you would not be joining for the lunch and afternoon tea).

Registration

Would you prefer a chair or a cushion for this course?*

Chair
Cushion

Personal Details

Name*

First Last

Email*

Phone*

Address

Street Address Address Line 2 City ZIP / Postal Code Country

Course Costs

This course includes 4 sessions plus 1 retreat day, as well as materials.

Are you a current DCI Dharma Friend Monthly Contributor?*

Yes
No

Would you like more information about becoming a Dharma Friend Monthly Contributor?

Yes, please
No, not at this time.

Mind and Its Potential Course Fee

Price:

Includes: Materials, 4 sessions + 1 Retreat Day including Vegetarian Lunch and Afternoon Tea

Mind and Its Potential Discounted Course Fee for Dharma Friend Monthly Contributors

Price:

Includes: Materials, 4 sessions + 1 Retreat Day including Vegetarian Lunch and Afternoon Tea

This field is hidden when viewing the form

Facility Contributions*

Total $60: I would like to pay the facility fee for all 6 classes now
Total $10: I would like to pay the first Sunday's facility fee now. Subsequent facility fees I will pay in cash on the day.
Total $0: I will pay each facility fee in cash on the day.

If you pay the facility contributions in advance, then if you miss a class, we will automatically send you a link to the audio recording.

Would you like to make an additional donation? (optional)

Yes
Not at this time.

We try to keep the costs low to enable as many as possible to benefit from our programs. We also offer scholarships to help those unable to afford course costs. If you are able and happy to make an additional donation it is most appreciated. Donations are eligible for tax rebates. Thank you.

Donation Amount

Any amount is most welcome. Please enter the amount you would like to donate in the box above. Donations are eligible for tax rebates as we are a Registered Charitable Trust.

Total Amount

$ 0.00

How would you like to pay?*

I would like to pay in advance by internet banking (manual).
I would like to pay in advance by internet banking (facilitated by POLI).
I would like to pay in advance by credit card or PayPal via secure PayPal. (Please note that PayPal take a percentage of the total).

Here are our Bank Details:

Name: Dorje Chang Institute for Wisdom Culture
Bank: ANZ
Account Number: 06-0589-0167320-00

Please mark payment “DB” + "your name"

What date will you pay by internet banking?

This will help us to confirm payment has been received.

Paying by POLi
When you have finished filling in this registration, press the ‘Submit Registration' button at the bottom of the page, which will take you to the secure POLi payment page. There you can select your bank, and then login securely to your bank to make payment. After successfully completing payment you and DCI will receive a POLi payment notification email.

Paying via PayPal
When you press ‘Submit Registration’ button below you will be taken to PayPal to process your payment using either a PayPal account or a credit card.

To use a credit card press the ‘Pay using your debit or credit card’ link at the bottom of the page.

What is the name of the Paypal Account OR name on the credit card you will use to pay with?

This will help us to confirm we have received your payment.

Please arrive early on the first Sunday you attend to complete payment. Thank you.

If possible, please try to arrive at least 15 minutes early and ideally bring exact change. This will help support class starting on time. Thank you!

Comments

Please provide us with any additional information which may help us. Feel free to include any practical questions you may have.

Join Our Mailing List

If you are already on our mailing list or wish to be added, please leave the box ticked.

After you hit the 'Submit Registration' button below, please check the following page for a confirmation message (or an error message – if more entries need filling in). Thank you.

If the form is complete you will see a confirmation message thanking you for registering. This is followed by an automatic email that includes the details of your registration. This means we have received your registration. IF you receive an error message, please fill in the missing information and hit submit again. Please check. If you don't receive a confirmation message, we have not received your registration.

Discovering Buddhism Registration