Bas

icPr
ani
cHeal
i
ngTeac
herTr
aini
ngCour
se Please
I
MPOR
TANT –PLEAS
EFI
LLI
NTHI Y(US
SFORM COMPLETEL EBLOCKLETTERS) affi
x
Your
ORGANI
SINGF
OUNDAT
ION:
YOGAVIDYAPRANI
CHE
ALI
NGF
OUNDAT
ION OF
recent
MAHARASHTRA
Phot o

Appr
ovedbyTr
ust
ee–Name:
¬¬_
LastAYLeveltak
en:
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ed:_
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Copyofcerti
fi
cat
eencl
osed:Yes No Comment
s:_
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Si
gnat
ure:
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PE
RSONALDE
TAI
LS
Na
me:
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_yr
s Sex
:M F

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dress:
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y St
ate PinCode
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elep
hone:__________
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Home) (Work/Mobil
e)
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tion:____
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Ma
rit
alSt
atus: Si
ngl
e Mar
ri
ed Educat
ion______________________________________________________

I
fmar
ri
ednoofChi
l
dren_
___Age_
___Yr
s. Spouseeducat
ion_
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I
fwor
king(
Job)
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gnat
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JobDescr
ipt
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Busi
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on_
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ionofBusi
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tner
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ehol
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ncomeRoughl
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Anyot
herQual
i
ficat
ion_
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WhyAppl
yi
ng_
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Tar
get
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Howwoul
dyouachi
ve.
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Pr
ani
cHea
lingCour
sest
aken

Cour
se Pl
aceCond
uct
ed Na
meofI
nst
ruct
or Mont
handY
ear

Basi
cPr
ani
cHeal
ing
AdvancedPr
ani
cHeal
ing
Pr
ani
cPsy
chot
her
apy
Achi
evi
ngOnenesswi
th
theHi
gherSoul
Ar
hat
icYoga
Pr
epar
ator
y
Level1
Level2
Level3.
1
Level3.
2
How of
tend
oyoup
ract
icet
hef
oll
owi
ng?(
Pleasespeci
fyf
requencyofpr
act
ice)

Pi
ll
arNo.1 Dai
ly Weekl
y Thr
icea Twi
ceaMont
h Remar
ks
Week
Ar
hat
icI
nvocat
ion
Shar
anagat
i

Pi
ll
arNo.2 Dai
ly Weekl
y Thr
icea Twi
ceaMont
h Remar
ks
Week
Physi
cal
andbr
eat
hingex
erci
ses
I
nnerRef
lect
ionFi
rm Resol
uti
on
Bl
ueTr
iangl
e

Pi
ll
arNo.3 Weekl
y Twi
ceaMont
h Thr
iceaMont
h Remar
ks
Medi
tat
iononTwi
nHear
ts
Medi
tat
ionont
heI
nnerBr
eat
h
Medi
tat
ionont
heSoul
(Bl
uePear
l)
Ar
hat
icDhyan
Ar
hat
icY
ogaL
evel
___
_(speci
fy)
Ar
hat
icY
ogaL
evel
___
_(speci
fy)
Anyot
hermedi
tat
ions(
speci
fy)
Subl
i
mat
ionofSexE
ner
gy

Pil
larNo.4
Servi
ce: 3Hour
s Ifmorespeci
fy___
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_Place(
s)wher
e
youdot
heser
vice _
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Ti
thi
ng:

1.
Tot
alamountdonat
edt
hisyearRs._
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2.
Aver
ageamountdonat
edpermont
hRs.
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MCKSTr
ustFund Wor
ldPr
ani
cHeal
i
ngFoundat
ionI
ndi
a(Ashr
am)
L
ocal
Foodf
ort
heHungr
yFoundat
ion Ot
her
s:Kar
micObl
i
gat
ions.
____________________
Anyot
heror
gani
zat
ion_
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_(NonKar
micObl
i
gat
ion)

Pi
ll
arNo.5
Namesofrecommendedbooksyouhavereadint
hel
ast12months:(AsgivenintheBasi
cbookorArhat
icNot
es)
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8._
9.Whichothercour
sesofMast
erChoaKokSuihaveyouat
tended?(
E.g.Cr
yst
alHeal
ing,Feng
Shuietc.
)
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Whatot herprogramsofpersonalgrowt
h/meditati
onhaveyou
at
tended?
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HowhasArh
ati
cyogachangedyourl
if
e?
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How has Arhati

c yoga helped you
per
sonal
l
y?
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How has Arhat

ic yoga hel
ped you
f
inanci
al
ly?
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Pl
easewr
it
edet
ail
sofa
lla
ilment
syouha
veha
dorha
ve(
howev
ert
ri
vi
alt
heyma
ybe)
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DE
CLARATI
ON

Iam par
ti
ci
pat
ingi
nthi
ssemi
naratmyownr
iskandofmyownf
reewi
l
l.It
akef
ullr
esponsi
bi
li
tyf
orpar
ti
ci
pat
ingi
n
t
hispr
ogr
amme.Ir
eleaseal
linst
ruct
ors,al
lor
gani
zer
sand assi
stant
soft
hissemi
narf
rom al
ldamages
what
soeverandwai
veal
lri
ght
stocompensat
iononcar
eofi
nj
ury
.Idecl
aret
hatIam physi
cal
l
yandment
all
yabl
e
t
opar
ti
ci
pat
eint
hissemi
narandwi
l
lkeepconf
ident
ialal
lthepr
oceedi
ngs.Iver
if
ythatt
hei
nfor
mat
iongi
ven
abovei
str
uet
obestofmyk
nowl
edge.

Pl
ac
e:

Dat
e:
Si
gnat
ure
Si
gnat
ure