Guru Puja Phase 2 Application Form
Email address *
UID ( Please give your UID in programs.org.in - if you do not have one please create one there and then fill this form) *
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Personal Details
First Name *
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Middle Name :
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Last Name *
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Gender *
:
Age : *
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Marital Status : *
Contact Details
Primary Email : *
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Mobile Number *
:
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Address *
:
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City *
:
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State
:
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Country *
:
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Professional Details
Profession *
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Art of living Teacher *
:
Required
TeacherType
Teacher Code
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Medical History
Please list any physical or mental health condition or ailment you have been treated/ hospitalized for:
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Note: Please provide the details if you have any of the conditions below. Medical History :
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Are you taking any prescribed medicine for any physical ailment or health condition? YES/NO *
Required
Gurupuja Phase 1 Program Details
Date (DD/MM/YY) *
approx date will do
MM
/
DD
/
YYYY
Place. (Country) : *
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Remarks
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Passport Number - for Internationals Only
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Date Of Issue Of Passport - For Internationals Only
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Date of Expiry of Passport - For Internationals Only
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I hereby declare that the above information is accurate to the best of my knowledge and belief. I fully understand that any information furnished above, if proved incorrect or false, will lead to my registration being cancelled . VVMVP will take whatever action it deems fit *
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