Enrollment Form: Good Life Zoroastrian Emblem

Good Life Program Registration

"*" indicates required fields

Name of Candidate*

First Middle Last

Name of Local Zoroastrian Association

Registration and Book Purchase

All participants are required to purchase the Good Life Book. Each participant will need to read the book and answer essay questions in the Good Life Workbook as part of the requirements for the Program.

Registration Fees*

Price:

Purchase the Good Life Book*

Purchase of the book is mandatory to complete the workbook essays that are part of the Good Life Program

Price:

Shipping*

By USPS

Local Pick Up at ZAGNY Dar-E-Mehr

Total

Email Address*

Please enter an email address where we can email the receipt of payment received

Billing & Shipping Address*

We will ship the books to the billing address entered below.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Credit Card*

Card Details

Cardholder Name

Phone

This field is for validation purposes and should be left unchanged.