Form

Sri Swami Vishwananda in Brazil
Belo Horizonte - March 11th - 13th, 2012

Registration form
Title*
First name*
Family name*
Spiritual Name
Enter your spiritual name, if you have been given one
E-mail*
Your personal email

Address

Street Address
Street Address Line 2
City	State / Province (for USA only)
Postal / Zip Code	Country

Your web site
Your personal web site or Facebook page if you have one
Birth Date
Day Month Year
Phone Number
- Area Code Phone Number
Mobile Phone Number
- Area Code Phone Number
Fax Number
- Area Code Phone Number
Main language*
Indicate your main language (mother tongue)
Other language
Indicate other languages you speak
I understand

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Event Registration
I wish to register to*

Darshan Mudra 2 Course
Darshan is free or charge.
Donations are welcomed.

Darshan égratis.

Donativossão bem vindos.
Mudra 2 course fee: Reais 170,00
(or 180,00 if paid in 2 instalments)

Curso de Mudras 2: Reais 170,00

(ou 180,00 parcelado em 2 x)
First time with Swami?*

Yes No
Coming with children?

Yes No
Sitting*

on a chair on the floor (bring cushion with)
Disabilities (add Comments if needed)

Handicapped In a wheel chair Blind & coming with a dog
Information
I read the Guidelines*

Yes!
Please read the "Darshan Guidelines"

Por favor leia asorientações do Darshan
I would like more information about

Bhakti Marga & Swami Vishwananda Bhakti Marga Newsletter Pilgrimages with Swami Special courses with Swami Atma Kriya Simply Meditation Om Healing Lunch4children (charity from Bhakti Marga)
More general information about Darshan & Satsang.
Contacts & Comments
Comments / Questions
Enter here any comments or questions
PAYMENT/PAGAMENTO

Please contact directly the organizer (see below) to arrange payment

"Mudra 2" fee is Reais 170,00 (or 180,00 if paid in 2 instalments)

Favor entrar em contato diretamente com a organizadora do evento (ver abaixo).
Venue/Local:

OLYMPICO CLUB. Rua Estevão Pinto, 783 - Serra

BELO HORIZONTE

Time/Horário:

Darshan: Sunday March 11th, at 18:00

Darshan: Domingo, 11 demarçoàs18:00

Mudra Course : Monday March 12th, at 18:00

Curso de Mudra: Segunda, 12 demarçoàs18:00

For more information, please contact directly the organizer:

Para maisinformações contatar diretamente a organizadora:

by email hfeichas@gmail.com or telephone: +31 93023103
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Sri Swami Vishwananda in Brazil

Belo Horizonte - March 11th - 13th, 2012

Event Registration

Information

Contacts & Comments