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Dancing Shiva Program Registration Form

Name(*)
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Address(*)
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City(*)
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State(*)
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Zip Code(*)
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Country(*)
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Home/Cell #(*)
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Birthday(*)
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Email(*)
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Education Completed(*)
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Major(*)
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Degree(*)
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Year Graduated(*)
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Current Profession(*)
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Career Satisfaction(*)
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Experience in Yoga & Ayurveda (Explain course, practice & related experience)(*)
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Reason for taking the program(*)
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Describe your general lifestyle and spiritual practices, lineage, meditation, diet and service to others(*)
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Approximately how many hours per week do you have available for yoga practice (sadhana), reading, studying, asana, pranayama, meditation and ayurvedic lifestyle?(*)
Please choose how many hours you have available

I accept the and understand the policies of the Yoga & Ayurveda Program(*)
Please accept the terms and conditions

By checking this box you certify that you understand and accept the policies of the Yoga and Ayurveda Program. This also confirms that all the information you have provided is accurate and true. You are acknowledging that you have read and fully understand the program guidelines, the tuition, the fees and the payment options.