Sign up for your next class@Shamballah Laboratory! Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Are you ok with us contacting you via email with newsletters, updates and offerings? * I am I am not Phone * (###) ### #### Date of Birth MM DD YYYY Have you previously worked with a practitioner in the Modern Mystery School? Yes No If yes, with whom> MMS Student Number Thank you!