APPLICATION FOR SIDDHA MEDITATION INTENSIVE
NAME: (Male/Female)
AGE: OCCUPATION:
COMPLETE ADDRESS:
TELEPHONE: Email:
I have/have not participated in any Siddha Meditation Intensive
before.
Declaration: "I have read and understood all the rules of the Siddha Meditation Intensive and shall follow them correctly".
The Registration fees of Rs. 1500/-(For Indians) US$50 (For Foreigners) is enclosed by means of : Demand Draft / Money Order (Non transferable & non refundable) .
Details:
CHOICE OF DATE OF INTENSIVE:
15th August 2013, 17th November 2013
I request you to kindly permit me to participate in the Siddha Meditation Intensive.
Date:
Signature
_______________________________________________________________________
For Siddha Yoga Dham Office use only:
Receipt No.: Date: Registration No.:
Permitted to participate
_____________________
Spiritual Head, Siddha Yoga Dham,