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SRCEPG
Shri Ram Centre For Excellence & Personal Growth
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Email
*
Your email
Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Your Age
*
Your answer
Your Academic Qualification:-
*
still studying (in school)
Intermediate
Graduate
Post Graduate
Doctorate
Percentage of marks in your 12th standard
*
Pass
above 50%
above 60%
above 70%
above 80%
will not like to share( it's fine☺️)
Have not given
Your Dream/Dream job/Dream Relationship/Dream Life
*
Your answer
What difficulties are you facing in realising it 🤔 ?
*
Your answer
Your Present Activity/Job/Occupation/Career
*
Your answer
Mobile Number
*
Your answer
Have you visited our website(
drbrijeshsir.com
) ?
*
Yes
No
Yes but have not read it
Do you feel convinced with our ideology(visit
www.drbrijeshsir.com
to know our ideology) ?
*
Yes
No
I will definitely read it after filling the form 😅
Can you define yourself ? If yes try to write about yourself in explanatory way in few words.
*
Your answer
Are you satisfied and happy with the life you are living at present ?
*
Yes
No
Maybe
What complaints do you have ?
*
Your answer
Are you thankful/grateful for something ? If yes name few things.
*
Your answer
Do you want to get rid of your vicious cycle ?
*
Yes
No
Maybe
Do you feel Loaded/ Burdened with any/some undisclosed secrets ?
*
Yes
No
Maybe
Do you wish to prepare yourself for an uninterrupted joyful & progressive life ?
*
Yes
No
Maybe
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