Application

Full Name*

Gender GenderFemaleMaleTransgenderNon binary

Email Address*

Phone number with a country code (+)*

Date of Birth*

Country*

Which of our offerings are you applying for?* Which of our offerings are you applying for?*Uk Yogini retreatNavaratri retreat AprilNavaratri retreat OctoberGuruji SadhanaAdvanced retreatSharabh Yoga onlineAdvanced retreatOnline Courses

Occupation*

Name of your emergency contact*

Q: What's your relationship to the emergency contact?*

Q: Do you have any history of psychological or emotional disturbances? If so, could you kindly describe below?*

Contact number (with + country code)*

Q: Are you currently taking any medication? If so, could you kindly describe below? *

Q: Are you currently in the care of a medical or natural health care practitioner? If so, could you kindly describe below?*

Are you currently using tobacco, alcohol, or recreational drugs?* Are you currently using tobacco, alcohol, or recreational drugs?*YesNo

What is your primary diet?* What is your primary diet?*VegetarianVeganNon-vegetarianOther

If the answer was yes, please describe.*

Q: Do you have any previous injuries that may affect your practice? If so, please describe.*

Q: Do you have any practices such as yoga, meditation or anything else related to spiritual growth or personal development? {please state how long you have been practicing and what these practices are.} If so, How do your practices affect your life? (Please answer in as many details as possible)*

Do you teach yoga, meditation or techniques related to personal growth? * Do you teach yoga, meditation or techniques related to personal growth? *YesNo

Q: How did you hear about Satya Loka, and why do you wish to participate in our programs?