Satya Sadhna

Name

Father's/Name

Gender

Male

Female

Marital status

Date Of Birth

Age

Education

Email Address

Phone(Home/Work)

Mobile

Mother Tongue

Other Languages you understand well

Hindi

English

Address

Pin Code

Native Country

Designation

Department

Company's Name

Office Address

Profile Photo

Upload ID

Medical Prescription

Sitting Option

Chair

Down

Is any Know person attending this course with you?

Yes

No

Has Any one in the family done a course ?

Yes

No

Any Physical ailment (use seperate sheet, if needed)

Yes

No

Any psycological ailment addiction (Give details on seperate sheet)

Yes

No

If yes,Kindly bring a fitness certificate from your doctor.

Yes

No

If taking any medicine regularly have you brought it with you

Yes

No

How did you learn about the course

Brief personal background Aim of joining the course present mental state, any special incident,family/social background,etc.

Do you have complete course previously?

Yes

No

First Course

Date First Course

First Place

Assist, Teacher

Last Course

Date First Course

First Place

Assist, Teacher

10 Day	20 Day	30 Day	50 Day	60 Day	Self Course	Service	Total Course

Do you practice this technique regularly?

Yes

No

What changes have you noticed in yourself by of meditation?

How many hours daily?

I have understood all rules and am prepared to strictly follow the time-table, rules till during and the end of the stay. I will strictly keep away from any other type of meditation, rites,rituals, fasting, recitation of mantras and prayers and refrain from keeping any religious/spiritual objects, as well as from all types of intoxicants and drugs for the entire duration of the stay.

Application