Class Interest Inquiry

Name
Email-Please make sure you type this correctly.
Email-Please retype, so we can make sure you type this correctly.
If you don't have email, you can still receive
our quarterly schedule and updates via U.S.P.S. (snail mail).

Street Address or P.O.Box
Town, State, Zip
Phone contact
Do you do Facebook? Please "like" us through our website button, and visit our page for updates and exciting tidbits!
 Yes, I do! 
 No--facewhat? 
Where did you hear about the Asheville Tantra School?
Tell us some more about your areas of interest...
 Energy and Breath Work 
 Sex and Psychology 
 Yoga 
 Somatic Awareness 
 Intimacy and Relationships 
 Anatomy 
 Permaculture and Tantra 
 Chi Gong 
 Fetish 
 Healing from Trauma 
 Women Only 
 Men Only 
 Polyamory 
 Couples 
 Transgender 
 Prostatectomy Support 
 Fertility 
 Personal Development 
 Massage 
 Other Interests 
If other, please detail/explain...
What other trainings and certifications have you taken or do you possess?
Have ever attended a class on tantra or sexual well being? if so when and where?
What levels of classes are you seeking?
 Personal development 
 Professional Certification 
 CEU's 
 Anything else?  
What class times are best for you?
 Weekends 
 Evenings 
 Business Lunch 
 Daytime 
 Other 
if other, please detail/explain...
What is your age range?
 18-24 
 25-34 
 35-44 
 45-54 
 55-64 
 65 and up 
Occupation
What are your favorite websites or magazines?
Would you be interested in helping us get the word out (passing out flyers, rack cards, etc)?
 Yes I'd love to 
 Maybe a little 
 No Sorry 
your confidential form will be sent directly to our school administrator at: ashevilletantra@gmail.com thank you for your time and interest.
We love class suggestions--what kinds of classes are you interested in taking?
Please take a moment & let us know what you think about our school & classes...
If so, what class? What is your feedback?
Do you have general questions about our school and courses?
THANK YOU FOR YOUR TIME--WE VALUE YOUR INPUT!
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