Registration

City you are from

Date / Month / Year

Name (Last)

First

Middle

Name I like to be called

Home Address (Street / P.O. Box)

City / Town

Pin Code

Country

Home Phone

Work Phone

Mobile No.

Age

Date of Birth

SEX

Qualification

Occupation

Husband Name / Father Name

Qualification

Occupation

Any Medical History/Allergic to

To help you to benefit fully, we ask that you take a moment to state specifically and answer the questions.

Answering these questions does not suggest or guarantee that you will achieve them. However, by being specific you will facilitate your participation. (You may attach additional pages if needed)

Answer the question in Yes / No

Are you intuitive?

Are you open to learning?

Are you clairvoyant?

Do you meditate?

Are you happy?

Do you feel young?

Do you read?

Do you do any charity?

Are you introvert?

Are you socially active?

Can you feel any sensation in your body?

Your Dreams?

Expectations from us?

Anything you would like to know about yourself?

Any incident of your life you would like to share?

Declaration

I hereby declare that the information provided is correct and to best of knowledge.