Application form for Jeevan Vidya Workshop in English at Dharwad, Karnataka (18

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Application form for Jeevan Vidya Workshop in English at Dharwad, Karnataka (18 - 25 February 2023)

Please note that the workshop is in the nature of an intensive immersive retreat that has to be attended in its entirety. It may not be attended partially. Participants are expected to arrive by the evening of 17th February, and may leave after lunch on the 25th of February, 2023.

Note that this particular iteration of the workshop will be conducted in English; participants are expected to be proficient in the language.
This form is an application for individual participation only.
(The workshop is for individual participation only. DO NOT plan/contrive to attend the workshop with your family / friends / spouse / partner etc.)
You should consider yourself duly registered only after you receive clear communication from us confirming your participation in the workshop.

Note that the number of applications we receive is much larger than the places available; so please fill in this form very carefully and in sufficient detail to improve your chances of acceptance.

Email *

CAUTION!! NOTE THAT THE WORKSHOP IS NOW OVERSUBSCRIBED. BUT PLEASE DO FILL IN THE FORM IF YOU ARE KEENLY INTERESTED AND WOULD LIKE TO BE PLACED ON OUR WAITING LIST FOR THIS EVENT.

Name *

Age *

Gender you identify with *

Male

Female

Other

Nationality *

Phone *

E-mail *

Address *

Education / Occupation / Work background *

Have you attended a Jeevan Vidya Workshop earlier? If yes, when and where? *

If you ever applied for this workshop earlier but could not be accommodated, please let us know when or for which workshop you had applied.

Please provide references of people (as many as you can) through whom you have learnt about this workshop. *

Reference 1: NAME OF PERSON, & YOUR CONNECTION TO THE PERSON

Please provide references of people through whom you have learnt about this workshop.

Reference 2: NAME OF PERSON, & YOUR CONNECTION TO THE PERSON

Please provide references of people through whom you have learnt about this workshop.

Reference 3: NAME OF PERSON, & YOUR CONNECTION TO THE PERSON

How do you think this workshop would be relevant to you? *

Anything else you would like to share, or tell us?

Your accommodation preference: *

I will be bringing my own tent to stay in. (We strongly recommend this option, especially if you own a tent or are able to procure one; this will offer you a safe and private sleeping space; we will have sufficient space and assistance available for rigging up tents.)

I will be happy with the dormitory accommodation and shared ashram-like facilities at the venue Suman Sangam.

I would like a separate suite with attached toilet, bath and kitchenette counter at the Naturopathy centre 0.5 km from the venue. I understand that I will have to bear the expenses for such accommodation (current tariff: upwards of Rs.1200 per day), and for any vehicle hired to take me to and from the workshop venue. I also understand that availability of such accommodation is likely to be very limited.