PAST LIFE REGRESSION & SPIRITUAL SCIENCE WORKSHOP LEVEL ONE

BY DR.K.NEWTON, M.D.
REGISTRATION FORM

1.

NAME: _______TARIT MOHAN___________________________________

2.

AGE: ___40_____________ 3. GENDER _______MALE______________

4.

RESIDENTIAL ADDRESS: __22 TEG BAHADUR ROAD , DALANWALA,

DEHRADUN

TEL.NO: __0135-2671680____________________________________
E-MAIL: _____tarit@vsnl.com_______________________________
5.

PROFESSION/OCCUPATION: _GENERAL MANAGER____________________

6.

OFFICE ADDRESS: __IMSI INDIA PVT LTD, DOON EXPRESS BUSINESS PARK,
SUBASHNAGAR, CLEMENTOWN, DEHRADUN
_____________________________________________
TEL.NO: _0135- 25257402_____________________________________

7.

WHY DO YOU WANT TO ATTEND THIS WORKSHOP?

1. FOR SELF HEALING AND TO ATAIN WISDOM TO LEAD A PEACEFUL LIFE
2. TO BE ABLE TO HEAR THE VOICE OF MY SPIRIT
3. TO IMPROVE MYSELF IN ORDER TO BE IN ALIGNMENT WITH NATURE

My signature on this form declares that I am willingly attending this Past Life
Regression Workshop.
I understand that this work is for Self Healing and
Spiritual Ascension.
Any need for professional therapeutic services must be
secured outside of this workshop.
Date:

Signature

PAST LIFE REGRESSION & SPIRITUAL

SCIENCE WORKSHOP, Dehradun
Received a sum of Rs. only towards the participation fee in the
Past Life Regression & Spiritual Science Workshop at Dehradun from

For Life Research Academy