English Retreat Registration - Moriah Retreat Center, Mangalore Live-In Retreat
Please note every person needs to register
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Moriah Retreat Center, 1-218/1, Moriah Charitable Trust, N.H. 75, Konalu, Nellyady, Mangalore, D. K. Karnataka-574229
CONTACT NO:  +919743533075/+91 9916316460
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NAME
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GENDER

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AGE
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CONTACT NUMBER
Is whatsapp available on the same number, mention - YES/NO
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EMERGENCY CONTACT NUMBER
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ADDRESS/PLACE
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DATE OF ARRIVAL
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DD
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MODE OF TRANSPORT FOR ARRIVAL
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DATE OF DEPARTURE
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YYYY
MODE OF TRANSPORT FOR DEPARTURE
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PURPOSE OF COMING
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OTHERS
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