Nagpur RegForm
1
Shiv Yog™ Siddha Scanning & Clairvoyance Shivi Service Tax No. AAJFG9307KSD001 DD need to be made in favor of “ GEETA Participation Fee comprising Basic Fee :__ DD No. ________ Bank _________ D ------------------------------------------------- Form No.: __________________ Name:_______________________ Registration done by: __________ SIDDHA APP Name (First Middle Surname): Date of Birth: Mobile No. : Marital Status: Address for Communication: City: State: Highest Qualification: SHIVYOG™ SHIVIR DESCRIPTION Shree Durga Saptashati Shivir Siddha Healing & Shambhavi Dhyan Advait Shree Vidya – Level I Advait Shree Vidya – Level II Advait Shree Vidya – Level III Infinite Dimesional Advait Shree Vidya Prati Prasav / Adv Prati Prasav Sadhna Art of Self Realisation / Art of Dying I am participating in the SHIVYOG™ program whatsoever. I will maintain the sanctity of th discipline during the program and I understa premises and I will be refused admission i transferable. Use of MOBILE PHONES is not pe program. Recording of the program conten asked to leave the venue and his registrat I confirm that all the information is t Signature of Applicant vir – Nagpur 2014 REGISTRATION ANJALI YOG LLP”, payable at New Delhi ________, Service Tax: _________, Total Participation F Dated: ____________ ----------------------------------------------------------- Date:__________________________ Receipt No.: ___________________ Donation Amount:_______ ___________________ Signature:______________ SCANNING & CLAIRVOYANCE SHIVIR PLICANT’S PERSONAL INFORMATION Gender: Male Female Email ID: PAN: ZIP: Country: Profession: Profession Shiv Yog™ Shivirs Attended Place / City Name (Where you attended this shivir first time) Month & Year (When you attended this shivir first time) DECLARATION at my own will. I take full responsibility for participating in th he program and keep the proceeding of the program confiden and that if my conduct is found to be inappropriate, I would in the program. The participation fee for the program is n ermitted inside the venue, you are advised to not to carry it with nt by any device or mode is strictly prohibited. Anyone fo tion will be cancelled. true to the best of my knowledge. Place Date Fee: _________ ----------------------------- : _____________ ______________ ______________ Please Paste your recent Passport size Photograph here . nal Specialization: No. of times (You attended this type of shivir) his program, its outcome ntial. I will maintain the be asked to vacate the non-refundable and non- h you while attending the ound recording will be e Nagpur-2014 (25 th - 30 th Sept)
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Shivyog
Transcript of Nagpur RegForm
Shiv Yog™ Siddha Scanning & Clairvoyance Shivir – Nagpur 2014
REGISTRATION
Service Tax No. AAJFG9307KSD001DD need to be made in favor of “ GEETANJALI YOG LLP”, payable at New DelhiParticipation Fee comprising Basic Fee:_________, Service Tax: _________, Total Participation Fee: _________DD No. ________ Bank _________ Dated: ____________
---------------------------------------------------------------------------------------------------------------------------------------
Form No.: __________________ Date:__________________________ Receipt No.: _____________
Name:_________________________________________ Donation Amount:_____________________
Registration done by: ____________________________ Signature:___________________________
SIDDHA SCANNING & CLAIRVOYANCE SHIVIR
APPLICANT’S PERSONAL INFORMATION
Name (First Middle Surname):
Date of Birth: Gender: Male Female
Please Paste yourrecent Passport size
Photograph here.
Mobile No. : Email ID:
Marital Status: PAN:
Address for Communication:
City: ZIP:
State: Country:
Highest Qualification: Profession: Professional Specialization:
Shiv Yog™ Shivirs Attended
SHIVYOG™ SHIVIR DESCRIPTIONPlace / City Name
(Where you attendedthis shivir first time)
Month & Year(When you attended this
shivir first time)
No. of times(You attended this
type of shivir)
Shree Durga Saptashati Shivir
Siddha Healing & Shambhavi Dhyan
Advait Shree Vidya – Level I
Advait Shree Vidya – Level II
Advait Shree Vidya – Level III
Infinite Dimesional Advait Shree Vidya
Prati Prasav / Adv Prati Prasav Sadhna
Art of Self Realisation / Art of Dying
DECLARATION
I am participating in the SHIVYOG™ program at my own will. I take full responsibility for participating in this program, its outcomewhatsoever. I wil l maintain the sanctity of the program and keep the proceeding of the program confidential. I will maintai n thediscipline during the program and I understand that if my conduct is found to be inappropriate, I would be asked to vacate th epremises and I wil l be refused admission in the program. The participation fee for the program is non-refundable and non-transferable. Use of MOBILE PHONES is not permitted inside the venue, you are advised to not to carry it with you while attendi ng theprogram. Recording of the program content by any device or mode is strictly prohibited. Anyone found recording will beasked to leave the venue and his registration will be cancelled.
I confirm that all the information is true to the best of my knowledge.
Signature of Applicant Place Date
Nagpur-2014(25th - 30th Sept)
Shiv Yog™ Siddha Scanning & Clairvoyance Shivir – Nagpur 2014
REGISTRATION
Service Tax No. AAJFG9307KSD001DD need to be made in favor of “ GEETANJALI YOG LLP”, payable at New DelhiParticipation Fee comprising Basic Fee:_________, Service Tax: _________, Total Participation Fee: _________DD No. ________ Bank _________ Dated: ____________
---------------------------------------------------------------------------------------------------------------------------------------
Form No.: __________________ Date:__________________________ Receipt No.: _____________
Name:_________________________________________ Donation Amount:_____________________
Registration done by: ____________________________ Signature:___________________________
SIDDHA SCANNING & CLAIRVOYANCE SHIVIR
APPLICANT’S PERSONAL INFORMATION
Name (First Middle Surname):
Date of Birth: Gender: Male Female
Please Paste yourrecent Passport size
Photograph here.
Mobile No. : Email ID:
Marital Status: PAN:
Address for Communication:
City: ZIP:
State: Country:
Highest Qualification: Profession: Professional Specialization:
Shiv Yog™ Shivirs Attended
SHIVYOG™ SHIVIR DESCRIPTIONPlace / City Name
(Where you attendedthis shivir first time)
Month & Year(When you attended this
shivir first time)
No. of times(You attended this
type of shivir)
Shree Durga Saptashati Shivir
Siddha Healing & Shambhavi Dhyan
Advait Shree Vidya – Level I
Advait Shree Vidya – Level II
Advait Shree Vidya – Level III
Infinite Dimesional Advait Shree Vidya
Prati Prasav / Adv Prati Prasav Sadhna
Art of Self Realisation / Art of Dying
DECLARATION
I am participating in the SHIVYOG™ program at my own will. I take full responsibility for participating in this program, its outcomewhatsoever. I wil l maintain the sanctity of the program and keep the proceeding of the program confidential. I will maintai n thediscipline during the program and I understand that if my conduct is found to be inappropriate, I would be asked to vacate th epremises and I wil l be refused admission in the program. The participation fee for the program is non-refundable and non-transferable. Use of MOBILE PHONES is not permitted inside the venue, you are advised to not to carry it with you while attendi ng theprogram. Recording of the program content by any device or mode is strictly prohibited. Anyone found recording will beasked to leave the venue and his registration will be cancelled.
I confirm that all the information is true to the best of my knowledge.
Signature of Applicant Place Date
Nagpur-2014(25th - 30th Sept)
Shiv Yog™ Siddha Scanning & Clairvoyance Shivir – Nagpur 2014
REGISTRATION
Service Tax No. AAJFG9307KSD001DD need to be made in favor of “ GEETANJALI YOG LLP”, payable at New DelhiParticipation Fee comprising Basic Fee:_________, Service Tax: _________, Total Participation Fee: _________DD No. ________ Bank _________ Dated: ____________
---------------------------------------------------------------------------------------------------------------------------------------
Form No.: __________________ Date:__________________________ Receipt No.: _____________
Name:_________________________________________ Donation Amount:_____________________
Registration done by: ____________________________ Signature:___________________________
SIDDHA SCANNING & CLAIRVOYANCE SHIVIR
APPLICANT’S PERSONAL INFORMATION
Name (First Middle Surname):
Date of Birth: Gender: Male Female
Please Paste yourrecent Passport size
Photograph here.
Mobile No. : Email ID:
Marital Status: PAN:
Address for Communication:
City: ZIP:
State: Country:
Highest Qualification: Profession: Professional Specialization:
Shiv Yog™ Shivirs Attended
SHIVYOG™ SHIVIR DESCRIPTIONPlace / City Name
(Where you attendedthis shivir first time)
Month & Year(When you attended this
shivir first time)
No. of times(You attended this
type of shivir)
Shree Durga Saptashati Shivir
Siddha Healing & Shambhavi Dhyan
Advait Shree Vidya – Level I
Advait Shree Vidya – Level II
Advait Shree Vidya – Level III
Infinite Dimesional Advait Shree Vidya
Prati Prasav / Adv Prati Prasav Sadhna
Art of Self Realisation / Art of Dying
DECLARATION
I am participating in the SHIVYOG™ program at my own will. I take full responsibility for participating in this program, its outcomewhatsoever. I wil l maintain the sanctity of the program and keep the proceeding of the program confidential. I will maintai n thediscipline during the program and I understand that if my conduct is found to be inappropriate, I would be asked to vacate th epremises and I wil l be refused admission in the program. The participation fee for the program is non-refundable and non-transferable. Use of MOBILE PHONES is not permitted inside the venue, you are advised to not to carry it with you while attendi ng theprogram. Recording of the program content by any device or mode is strictly prohibited. Anyone found recording will beasked to leave the venue and his registration will be cancelled.
I confirm that all the information is true to the best of my knowledge.
Signature of Applicant Place Date
Nagpur-2014(25th - 30th Sept)
