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3S Program Registration
Class Location :Location.
Beginning Date :
Class Timing :
Name :
Birth Date :
Gender : MaleFemale
Address :
Education :
Profession :
Phone :
E-Mail :
Facebook Id :
1. Any previous exercise / yoga / meditation training? :
2. I prefer exercising (select one or more) : StandingSittingLying downCombination
3. Any previous Pranayama or Reiki training? :
4. Types / Techniques regularly practiced (items 1/2/3/4)? :
5. How long have you been practicing? :
6. Time of day & duration of yoga / meditation / exercise? :
7. How often (daily, weekly)? :
8. How long can you comfortably sit during meditation? :
9. Are you comfortable sitting on the floor?
How long?
10. Specific physical / emotional / health / relationship concerns that you wish to overcome or dissolve?
a. Physical :
b. Health :
c. Emotional :
d. Relationship :
Course Duration : 1 Month2 Month3 MonthRetreat / Shibir
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