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Kumbha Mela Travel Itinerary Form
Nithyanandam! In order for us to prepare for your arrival and registration, please let us know your travel itinerary as well as the date and time of your arrival at the airport or other point of destination, e.i. train station. We need this information to be provided by the 17th of April.

Each participant should fill out this form separately. For families, each member should also fill out this form separately including children.

Please note that you will need to make your own travel arrangements to the Nithyananda Peetham campus in Ujjain.

Shuddhadvaitam @ Simhasta Kumbh Mela Ujjain, April 17th - May 24th, 2016
Legal First Name *
Legal name as in your passport (not your spiritual name)
Your answer
Legal Last Name *
Legal name as in your passport (not your spiritual name)
Your answer
Spiritual Name
(if you have one)
Your answer
Your ID number *
Your answer
Date of Birth *
Your answer
Gender *
Marital Status *
Blood Group *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip / Postal code *
Your answer
Country *
Your answer
Occupation *
Your answer
Email ID *
Your answer
Phone Number *
Your answer
Emergency number *
Your answer
How Did You Come To Know of Swamiji? *
How did you learn about the Shuddhadvaitam program? *
Program will be in English. If you cannot understand English and need translation in any other language, please mention here. We will try our best to match your requirement, however we do guaranty that this will be satisfied. Please kindly e-mail support@innerawakening.org to confirm if translator has been arranged. TRANSLATION NEEDED
Your answer
Are there any food allergies that we need to be aware of? *
Your answer
Are there any medical conditions or medications that we need to be aware of? *
Your answer
Port of Arrival *
Required
Flight / Train / Bus Arrival Time *
(if known)
MM
/
DD
/
YYYY
Time
:
Airline & Flight Number
(if known)
Your answer
Leaving Date & Time from Nithyananda Peetham *
MM
/
DD
/
YYYY
Time
:
QUESTIONS & COMMENTS
Your answer
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