Application Form Yogi Hari's Ashram

Please fill in this application form and send your deposit or full payment - check or money order payable to Nada Productions; no credit card! - and the discription of your background to Yogi Hari's Ashram - 12750 SW 33rd St. - Miramar, FL 33027 - USA

In case you prefer to inscribe by paper mail, here you find a printable application form in pdf format.

First Name:

Last Name:

Address:

City:

State:

Zip, Postal Code:

Country:

Home Phone:

Email:

Mobile Phone:

Date of Birth:

Gender:
female male ; Age:

Occupation:

Talents:

Practice Hatha Yoga since:

Hatha Yoga Method if any:

Practice Meditation since:

Meditation Method if any:

Teaching Hatha Yoga:
yes no
Teaching Method:

I learned about this course from:

English is my primary language:
yes no
If no - my primary language is:

I sign up for

Teacher Certification Course, 06/18/2010 - 07/02/2010
Memorial Weekend Retreat with Cooking Workshop, 06/28/2010 - 06/30/2010
Yoga Day, 06/30/2010
Advanced Teacher Certification Course, 07/02/2010 - 07/23/2010
Disciples Retreat, 07/24/2010 - 07/31/2010
Yoga Day, 08/01/2010
Weekend Teacher Certification Course, 08/27/2010 - 10/03/2010
Sampoorna Nada Yoga Weekend Retreat with Cooking Workshop , 10/08/2010 - 10/10/2010
Teacher Certification Course, 11/05/2010 - 11/19/2010
Yoga Day, 12/05/2010

First Name:		Last Name:
Address:		City:
State:		Zip, Postal Code:
Country:		Home Phone:
Email:		Mobile Phone:
Date of Birth:		Gender:	female male ; Age:
Occupation:
Talents:
Practice Hatha Yoga since:		Hatha Yoga Method if any:
Practice Meditation since:		Meditation Method if any:
Teaching Hatha Yoga:	yes no	Teaching Method:
I learned about this course from:
English is my primary language:	yes no	If no - my primary language is:

	Teacher Certification Course, 06/18/2010 - 07/02/2010
	Memorial Weekend Retreat with Cooking Workshop, 06/28/2010 - 06/30/2010
	Yoga Day, 06/30/2010
	Advanced Teacher Certification Course, 07/02/2010 - 07/23/2010
	Disciples Retreat, 07/24/2010 - 07/31/2010
	Yoga Day, 08/01/2010
	Weekend Teacher Certification Course, 08/27/2010 - 10/03/2010
	Sampoorna Nada Yoga Weekend Retreat with Cooking Workshop , 10/08/2010 - 10/10/2010
	Teacher Certification Course, 11/05/2010 - 11/19/2010
	Yoga Day, 12/05/2010