Chhatralay Application Form
Form A
Personal Information
Do you intent to reside in Chhatralay?
*
Yes
No
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Student Name
*
First Name
Middle Name
Last Name
Birth Month
*
Please Select
January
February
March
April
May
June
July
August
September
October
November
December
Birth Year
*
eg. 1994
Preferred Centre
*
Please Select
Adelaide
Brisbane
Cairns
Canberra
Geelong
Hobart
Melbourne
Newcastle
Sydney
Wollongong
Other
If other
Recipient Email
example@example.com
Student E-mail
*
example@example.com
Mobile Number
*
Marital Status
*
Single
Married
Separated
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Estimated Date of Arrival at the Chhatralay
*
-
Month
-
Day
Year
Date
Visa Status(subclass)
*
eg. Subclass 500: Student Visa
Visa Expiry Date
*
-
Month
-
Day
Year
Date
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Family Information
Father's Name
*
First Name
Last Name
Mother's Name
*
First Name
Last Name
Parent's Phone Number
*
Please enter a valid phone number.
Parent's Email Address
example@example.com
Residential Address in India
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Native Town
*
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References
Personal References 1
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Relationship
*
Parent
Friend
Relative
Employer
Personal Reference 2
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Relationship
*
Parent
Friend
Relative
Employer
Satsangi/Karyaker Reference 1
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Relationship
*
Parent
Friend
Relative
Employer
Satsangi/Karyaker Reference 2
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Relationship
*
Parent
Friend
Relative
Employer
Pujya Santo's Reference
Pujya Sant Name
Mandir
eg. Surat Mandir
Phone Number
Please enter a valid phone number.
Please upload a reference letter (optional)
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Satsang Information
Are you coming from a Satsangi Family?
*
Yes
No
For how long have you been in Satsang for? (no. of years)
*
Do you do Nitya Puja?
*
Yes
No
Do you observe regular Ekadashi?
*
Yes
No
Have you appeared for Satsang Exam?
*
Yes
No
Do you do Seva?
*
Yes
No
Which Department?
*
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Additional Comments
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