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Application for Formal Initiary Instruction (Diksha) into Neelakantha Meditation
June 6-7, 2020
CONTACT INFORMATION
First Name *
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Last Name *
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Email Address *
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Date of Birth *
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Authorized Teacher *
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Style of Meditation *
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How did you hear about Neelakantha Meditation? If ‘friend’ or ‘teacher’ please tell us whom: *
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CONFIDENTIALITY AGREEMENT
By means of my signature below, I am formally applying for Initiatory Instruction into NEELAKANTHA MEDITATION. I understand and agree that this INITIATION and Formal Instruction are purely for the advancement of my personal spiritual path. I agree that the mantra I will receive and all of the initiatory details and specific instructions regarding NEELAKANTHA MEDITATION are purely for my own individual use. I further agree that I will forever keep private and not disclose this mantra to anyone else in any form, spoken or written or by means of any other medium. I will refrain from speaking specifically or indicating through any format whatsoever the specific details of Initiatory Instruction that I will receive regarding the method of NEELAKANTHA MEDITATION.

By my signature below, I signify and pledge that I understand the nature of this agreement to be permanently binding on me. This confidentiality agreement is freely signed by me after having had the opportunity to ask any questions I might have about it. I further understand that my signature on this confidentiality agreement is necessary for me to receive the Initiatory Instruction that is being offered to me by the above named Authorized Teacher, and known as NEELAKANTHA MEDITATION. In consideration of this, and in full agreement with all of the above, I affix my signature below.
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