Register – Himalaya Yoga

Register For Yoga Courses

TRAINING / COURSE	DATE
TTC(Teachers Training / Yoga Instructors Course ) 1 MONTH	EVERY MONTH IN ENGLISH & HINDI
HEALTH MANAGEMENT COURSE 10 DAYS	15 TO 30 EVERY MONTH
WEEK DAY COURSE 7 DAYS	ALTERNATE WEEK EVERY MONTH
WEEKENDS RETREAT 3 DAYS	EVERY WEAKENDS

APPLICATION FORM

FOR YOGA TRAINING

Himalaya Yoga Holistic Living Institute

Bhimtal, Nainital, Uttarakhand, India, 263136

Name *

First

Last

Diksha: Mantra / Jignasu / Karma / Poorna (circle one) Given by: *

Spiritual name (if any):

Date of birth: *

Gender *

Male
Female

Marital status *

Married
Unmarried

Phone Number: Home

Phone Number: Mobile *

Phone Number: Work

Permanent Address:

Permanent Address Pin/Zip

Present Address (if different):

Present Address Pin/Zip (copy)

Course that you want to Attend: *

PERSONAL IDENTIFICATION – Driver's Licence *

Single Line Text

PERSONAL IDENTIFICATION- Voter ID:

PERSONAL IDENTIFICATION – AADHAAR UID *

Email *

Website

Facebook ID

Twitter ID

Present Nationality: *

Nationality At Birth: *

Name, contact no. and/or e‐mail address of a Himalaya Yoga teacher as a reference:

Overseas applicants to provide Passport Number

Overseas applicants passport Issued by:

Overseas applicants passport valid until:

Overseas applicants Birthplace:

Native language:

English proficiency: *

Other spoken languages:

level of proficiency in other languages:

If you have any current physical health problems, allergies, illnesses or diseases, give full details on a SEPARATE SHEET; including medication being taken, restrictions in and management of the condition, and provide below the contact details and phone number of your doctor in the case of an emergency: *

Have you suffered from any major illness in the past? *

If yes, give details:

Do you have a history of any mental health issues, i.e., anxiety, panic attacks, depression, etc.? *

If yes, give details of symptoms, duration, treatment and present condition:

If you have any current mental or emotional health issues please give full details on a SEPARATE SHEET; including medication being taken, restrictions in management of the issue, and provide below the contact details and phone number of your doctor in the case of an emergency.

Note:- all the above course conducted by Himalaya yoga holistic living institute qualified teachers Lodgings and fooding also available during this period.

Register For Yoga Courses

APPLICATION FORM

FOR YOGA TRAINING

Note:- all the above course conducted by Himalaya yoga holistic living institute qualified teachers Lodgings and fooding also available during this period.

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