Yo'u' n I Aradhana
Kindly fill the details and help us help you.
Respect to Women...Respect to all Moms
I) BASIC DETAILS
1. First Name *
Your answer
1. Last Name *
Your answer
2. Date of Birth *
MM
/
DD
/
YYYY
3. Age *
Your answer
4. Place of Birth/ Native Place *
Your answer
5. Gender *
6. Mother Tongue *
Your answer
7. Contact Number *
Your answer
8. Email ID *
Your answer
9. Language Preference of Communication *
Your answer
10. Religion *
Your answer
11. Relationship Status *
12. Work Status *
13. Education Qualification *
Your answer
14. Leisure Activity/Activities *
Your answer
15. Like to have Free Family Counselling *
II) Program Related
Aradhana of Love offers following programs. Kindly choose option wisely.
16. Any Expecting Mother/ Plan for Family *
17. Any Child in Family *
18. Career Pursuing in *
Your answer
18. Any Career Guidance Required *
19. Any Parental Guidance/ Activity/ Workshop needed to bond with children *
19. Anybody you would like to recommend ? *
Your answer
20. If Free counselling needed, mention available Date, Venue preference, mode of communication, time. *
Your answer
21. Pre Marriage Counselling Interested Workshop/ Activity / Sessions *
22. Personality Development in any Family Member Required. Specify which aspect to be focused? *
Your answer
23. Talent/ Hobbies in Family *
Your answer
24. What Talent/Hobby you aspire to Learn *
Your answer
25. Do you want to Barter/exchange the service of your Talent in return of learning another one? Mention available time, place, date, time. *
III) Counselling Details
Defining Counselling in your terms
26. What do you mean by counselling?
Your answer
27. Do you think counselling should be availed by your Family *
28. In any of above part II category would you like any service from Aradhana of Love to help you with Y/N and Why? *
Your answer
29. Would you like to recommend someone and why? *
Your answer
30. Which specific area you want to be focussed with respect to counselling?Eg. Children, Parenting, Career, Personlity Dev etc *
Your answer
Acknowledgement: These details shall not be forwarded to anyone.
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