Maha Sivaratri Festival

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1 Welcome

Guest 1		First Name* Last Name* Gender* Male Female Email*
Guest 1		First Name* Last Name* Gender* Male Female Email*

All the information entered here will be kept private. Please fill out as much as you can. Required fields have a red *

Spiritual Name
Gender *	Male Female
Birth Date *
Marital Status
Languages Spoken
Phone (mobile) *
Address
Address 2
City
State/Prov.
Zip/Postal
Country
Emergency Contact Info - Name
How did you hear about us?
Sivananda TTC Graduate?	yes no
Yoga Experience	Please describe your experience with yoga and meditation
Occupation	Please describe your work history
Education	Please describe any formal or informal education experience.
Skills	Any additional skills that you think would be useful such as cooking, carpentry, gardening, landscaping, etc?
Medical Issues	Enter "none" if you have no issues
Sivananda Member?	Are you a member of a Sivananda Center, which one?
Comments or Special Needs
Special Diet
Terms and Conditions *	I accept the terms and conditions.All deposits and payments made to Sivananda Ashram Yoga Farm are non-refundable unless canceled within 24 hours of booking. If you need to cancel or reschedule at any time after this initial period we are happy to accommodate you; your payments will be converted to an Ashram credit which you may use for up to twelve months from the time of cancellation for either course tuition or accommodations, or both.
Email newsletter	Please send me the email newsletter Do not send me the email newsletter

$	General Donation This donation goes towards the general functioning of the ashram.
$	Building Donation This donation helps the new projects at the ashram. Currently we are re-building the bathhouse and building a new Krishna temple roof.
$	TTC Scholarship donation This donation helps to support under privileged students to take the TTC.

Credit card fee	I agree to cover the costs of processing this registration by paying the credit card fees. We are charged an average of 4% in payment processing fees. By offsetting a portion of these fees, you allow us to direct more of our revenue to offering life-changing programs and maintaining our beautiful property. When this box is checked, we will add 2% to your booking total. Thank you for your support..
2% Credit card fee	$0

Sub Total	$0

Donations	$0

Taxes	$0

0% Deposit	$0

Due Now	$0 $0

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