Download - Kolkata RegForm
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8/11/2019 Kolkata RegForm
1/1Shiv Yog Advance Prati Prasav Sadhana Kolk
Service Tax No. AAJFG9307KSD001DD need to be made in favor of GEETAParticipation Fee comprising Basic Fee:_ DD N o. ________ Bank _________ D
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Form No.: __________________
Name:______________________
Registration done by: _________
ADVA
AP
Name (First Middle Surname):
Date of Birth:
Mobile No. :
Marital Status:
Address for Communication:
City:
State:
Highest Qualification:
SHIVYOG SHIVIR DESCRIPTION
Shree Durga Saptashati Shivir
Siddha Healing & Shambhavi Dhyan
Advait Shree Vidya Level I
Advait Shree Vidya Level II
Advait Shree Vidya Level III
Infinite Dimesional Advait Shree Vidya
Prati Prasav / Adv Prati Prasav Sadhna
Art of Self Realisation / Art of Dying
I am participating in the SHIVYOG programwhatsoever. I wi l l maintain the sanctity of t
disc ipl ine during the program and I understapremises and I wi ll be refused admission itr ans fe ra ble. Us e o f MO BI LE PH ON ES i s no t p eprogram. Recording of the program contea sk ed t o l ea ve th e v en ue an d h is re gi st ra
I conf irm that al l the information is t
Signature of Applicant
ata 2014
REGISTRATION
NJALI YOG LLP , payab le at New Delh i
_______, Service Tax: _________, Total Participationated: ____________
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Date:________________________ __ Receipt No.:
__________________ Donation Amount:_______
__________________ Signature:_____________
NCE PRATI PRASAV SADHANA
PLICANTS PERSONAL INFORMATION
Gender: Male Female
Email ID:
PAN:
ZIP:
Country:
Profession: Profession
Shiv Yog Shivirs Attended
Place / City Name
(Where you attended
this shivir first time)
Month & Year(When you attended this
shivir first time)
DECLARATION
at my own wi l l. I take fu l l responsibil i ty for part ic ipating in the program and keep the proceed ing o f the program con fi de
nd that if my conduct is found to be inappropriate, I wouldn the program. The participation fee for the program is nrmitted inside the venue, you are advised to not to carry it witt b y a ny d ev ic e o r m od e i s st ri ct ly p ro hi bi te d. A ny on e fion will be cancelled.
rue to the best of my knowledge.
Place Date
ee: _________
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_____________
______________
_____________
Please Paste yourrecent Passport size
Photograph here.
al Specialization:
No. of times(You attended this
type of shivir)
i s program, i ts outcome tial. I wil l maintain the
be asked to vacate the on-refundable and non-
you while attending the und recording will be
Kolkata-2014
(6th - 10thAug)