Yoga Course Registration

Registering for Course:	------ Select One ------ Beginner Yoga: Sept 15th - Sept 26th 2008 Beginner Yoga: Oct 20th - Oct 31st 2008 Beginner Yoga: Nov 1st - Nov 12th 2008 Beginner Yoga: Dec 8th - Dec 19th 2008 Beginner Yoga: Jan 5th - Jan 16th 2009 Beginner Yoga: Feb 2nd - Feb 13th 2009 Yoga Teacher Training Course: Sept 15th – Oct 18th, 2008
Your Name:
Number of Family Members Coming:
Date of Arrival at Parmarth:
Address:
City:
State:
Zip code/ PIN code
Country:
Phone:
Fax:
E-mail:
Profession:
Do you have any physical ailments or disabilities?
Previous Yoga Experience:
Any other Comments or Enquiry:
How did you hear about us?	------ Select One ------ Family Friend Internet Search Engines Other
Nationality:
Passport number:
Place of Issue:
Date of Issue:
Date of Expiry:
Date of Birth: