Prajna Foundation

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1. Name

2. Age

Date of Birth

3. Gender

Male

Female

4. Occupation

5. Address

6. Mobile Number

WhatsApp Number

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7. Have you completed any five-day meditation course before?

Yes

8. New Students:
Have you any previous experience with meditation techniques?

Yes

9. Old Students:
Total number of courses completed:

10. Do you have any physical or mental health problems or diseases?

Yes

If yes, what is the present condition?

Declaration

I acknowledge that I have carefully read and understood the code of discipline for the meditation course. I agree to stay on the course site and follow all the rules and regulations for the duration of the course.

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Declaration