Student Registration Form
Fill out the form carefully for registration
Student Name
*
First Name
Middle Name
Last Name
Birth Date
Please Select
January
February
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Month
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1
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Day
Please Select
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1924
Year
Gender
Please Select
Male
Female
N/A
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Students's Email
*
Mobile Number
*
-
Area Code
Phone Number
Emergency Contact
*
-
Area Code
Phone Number
Do You Have Any Yoga Experience
How Did You Find Us?
Searched on google
Saw our Instagram profile
Friend suggested me
Saw a google Advt.
Saw a FB Advt.
I received an email
Courses
Please Select
Weekly 6 days meditation & yoga retreat
200 Hour Online Yoga TTC
Laughter Yoga TTC
200 Hour Meditation Yoga TTC
Pranayama Yoga TTC
100 Hours Yoga Course
200 Hours Yoga TTC
300 Hours Yoga TTC
500 Hours Yoga TTC
200 Hours Yoga TTC In Russia
Anti Cancer Program
Anti Depression Program
200 Hour Yoga TTC in Goa
200 Hour Yoga TTC in Kerala
200 Hour Yoga TTC in Uttarkashi Himalayas
Coupon Code (If Any)
Choose Course Start Date
Date
Do you have any food related allergies?
Do you have any medical or health related issue we should know about?
Accommodation
*
Triple Shared Room
Quadruple Shared Room
Shared Room
Private Room
Additional Comments
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Registration Fees
$
300
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