Mantra/Puja/Homam Request
Request form for Mantra Intitation or Puja Request or Homam/Yagna Request
Name *
Your answer
Father’s Name
Your answer
Approximate Age *
Your answer
Contact Address *
Your answer
Contact Phone Number
Your answer
Email Address *
Your answer
Gender *
Your answer
Native Place
Your answer
Gotra (Leave blank if not known)
Your answer
Nakshatra -Birth Star(Leave blank if not known)
Your answer
Rashi(Leave blank if not known)
Your answer
Name of Mantra/Puja for which Initiation is requested or Homam/Yagna Requested *
Whether you can travel to Chennai/Tiruvallur *
Tiruvallur is 40 Kms from Chennai
Your answer
Other spiritual practices followed
Your answer
Languages known
Your answer
Any other relevant comments
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service