Application form for Jeevan Vidya Workshop at Dharwad, Karnataka (19

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Application form for Jeevan Vidya Workshop at Dharwad, Karnataka (19 - 26 March 2022)

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 18th March, and may leave after lunch on the 26th of March, 2022.
This form is an application for individual participation only.
(The workshop is for individual participation only. DO NOT plan on attending 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.

Please fill in this form very carefully and in sufficient detail to improve your chances of acceptance.

Note that for this iteration of the workshop, priority will be given to those whose participation in the March 2020 workshop had been confirmed by us and who figured in the final list of participants for the event (which had to be cancelled at the eleventh hour due to the pandemic). Please indicate in the relevant section of the form if you fall into this category.

Email *

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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.

If you had applied specifically for the Jeevan Vidya workshop scheduled to be held at Dharwad from 21-28 March 2020, and were offered a place in it, and were on our final list of participants slated to attend that workshop (which was cancelled due to the pandemic), please indicate that here so that you can be granted priority.

Yes, I was accepted for participation in the March 2020 workshop and was on the final list of participants slated to attend that event.

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.