MBPH Class Application

Important Information:

  1. The participant has to be committed in attending all 8 sessions.
  2. After the application form is received, the instructor will contact the applicant to see if it is suitable for the applicant to attend the program. The center preserves the right to decide the acceptance of an application.
  3. Payment Method (The applicant is required to settle the payment within 7 days after the application is accepted):
    • 1. FPS (7-digit FPS ID: 8361966) *Please put your name in the remark and provide the record of payment.
    • 2. To mail a cheque with the confirmation notification to “Breathe and Smile Mindbody Wellbeing Center, P.O. Box 88446, Sham Shui Po Post Office, Kowloon, Hong Kong”. Please send a crossed cheque payable to “Breathe and Smile Mindbody Wellbeing Center Limited”.
  4. If the participant withdraws from the program after payment, the fee would not be refunded.
  5. If the participant is absent from the class, no make up class would be arranged.


Name (Chinese):

Name (English)*:




Correspondence Address*:

Mobile Phone No.*:


Emergency Contact


Contact Tel. No.*:

How you know about this program?*

Why you want to attend this program?*:

Do you ever have any mental illness?*

Please specify