Yoga for NextGenDocs
A Benefit for the Women’s Reproductive Health Research Program at UCLA
under the direction of Dr. Daniel Dumesic

Co-Sponsored by
Santa Monica Bay Woman’s Club and Santa Monica Sports Club
September 20, 2015 from 11:00-2:00
Santa Monica Bay Woman’s Club
1210 Fourth Street
Santa Monica, CA 90401

For event-related questions, please contact Tery Schooler at tschooler@mednet.ucla.edu

Your contribution is greatly appreciated!
Participant Levels:
Child's Pose - $25*
Happy Baby - $50
Dolphin - $75
Warrior I - $100
Warrior II - $200
Warrior III - $300
Mountain - $500
Shavasana - $1,000
* Suggested donation for participants is $25. Registration is required to attend but a donation is suggested.
To register offline, please contact Tery Schooler (tschooler@mednet.ucla.edu).



Required fields are indicated with an asterisk (*).
 
Registration
Please indicate your level of participation.

I/We will:
 
*I would like to make a new gift of    Other $  


Personal
Title:
 
* First name:  
  Middle name:
* Last name:  
  Suffix:

Joint Gift
* This is a joint gift with my spouse/partner:
 

Contact Information
* Street:  
 
U.S. Addresses  
*   City, State, Zip:
 
 
 
Non-U.S. Addresses  
  Non-U.S. City/County
  or Province/Postal Code:
 
  Country:
 
* This address is my:  
* Home telephone:    
Business telephone:  

* E-mail address:  
* This e-mail is my:  

Matching Gift

  My/my spouse's employer will match my gift.
  Company name for matching gifts:
  This company is:
Tribute Gift
Please check this box if you would like to honor a family member, faculty member, business associate, community leader, or other with your contribution.
 
Payment method:
This gift is anonymous
 
Please indicate the full name(s) of the attendee(s) you are registering for the event:
 

 
Comments: