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CHILDRENīS COURSE APPLICATION FORM

 

* I would like to participate in the Children's Anapana Meditation Course from dt:_________ to dt:___________ at _________________________________________.

* I undertake to observe five precepts, namely, practicing abstention from killing, stealing, lying, sexual misconduct and use of intoxicants. I undertake to abide by the course Timetable and discipline.

* I also agree to stay for the entire duration of the course

 

Signature:                                                  Date:

 

 

FULL NAME :

GIRL/BOY :                      AGE:

FULL ADDRESS :

 

PINCODE:

PHONE NOS :

E-MAIL :

EDUCATION:

SCHOOL :

MOTHER TONGUE:

ANY PHYSICAL AILMENTS:

 

 

ANY MENTAL AILMENTS:

 

 

ANY MEDICATION :

 

 

ANY OTHER TYPE OF MEDITATION PRACTICED BEFORE :

IF YOU ARE AN OLD STUDENT (Have you attended any Anapana courses in the past?)

FIRST COURSE:

LAST COURSE:

TOTAL NO OF COURSES:

ARE YOU PRACTICING DAILY: