North India Seva Retreat 2020 Registration

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Please fill out all required questions. A copy of your responses will be sent to your email after successful completion.

Email *

Full Name (Please write it *exactly* as written in your Passport) *

Preferred name (or nickname)

Date of birth (month, day, year, in that order) *

YYYY

Complete Home Address *

Please include street address; city; state; ZIP code and country if outside the USA

Best phone number to reach you *

Just in case we need to get a hold of you more quickly than via email in an emergency only. Please include the country code if outside the USA or Canada.

Passport Country of issue *

Passport number *

The expiration date of passport *

Important note: Your passport must have at least six months validity from the end of the trip and at least two blank pages in it. If you wish to register for this trip but have an expired or soon-to-be-expired passport, you can still enter your old passport info and we will update it when you send us the new information.

YYYY

Will you have a single room or a shared room on this trip? *

If you are willing to share but don't have a roommate already, we will put you with a roommate.

Shared Room

I do not want a roommate and will pay $200 extra for a single (limited single rooms are available on a first come, first serve basis)

If you are sharing a room with someone you know, what is your roommate's name?

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