Questionnaire Puri

• Fill in the answers to questions below OR email the answers to pilgrimage@anandaindia.org OR send by post.
• Payments by cheque/bank draft to “Ananda Sangha Delhi”, or in Delhi by cash. Mail to Keshava Taylor, Ananda Sangha, N-100, Panchsheel Park, Outer Ring Road, New Delhi 110017. (Ph. 9899200605). Online transfer also available.
• Spaces are limited. Your participation is confirmed only when we approve your application and receive first payment of Rs. 5000. Balance of fee due one month prior to the beginning of the pilgrimage.
• In case of cancellation, Rs. 1000 of fee is non-refundable. Cancellation close to date of departure may incur additional costs.

Please answer the following
(Please select “pilgrimage you wish to join” as “Pilgrimage-P”):

Select Pilgrimage you wish to join —Please choose an option—Varanasi

Full Name (required)
Name I wish to be called if different than above
Age (required)
MaleFemale

Postal Address (required)

City (required)

Mobile (required)

Email (required)

PAN Number (required)

Name and phone of a person not travelling with you, to contact in case of emergency
Name (required)
Phone Number of emergency contact (required)

I prefer : —Please choose an option—Twin Room (Two separate beds in a room)Double Room (One large bed for 2 people)Single Room (One person in a room)

I wish to share a room with:
If you don’t have a roommate, we’ll try to connect you with another single pilgrim. If a suitable roommate can’t be found, you’ll need to pay for single occupancy. If you snore, we ask you to stay with someone you know well or pay for single occupancy.

Do you have a medical condition that could limit your participation? (e.g., knowing you have difficulty with stairs would help us choose the best hotel room for you.)
YesNo
More details

What has inspired you to consider this pilgrimage?

Have you attended other Ananda programmes?
YesNo

Have you read books by Paramhansa Yogananda or Swami Kriyananda?
YesNo

Do you practice meditation?
YesNo

What kind of meditation do you practice?
What I've learned from Ananda SanghaI am a KriyabanOther Meditation

Comments or Questions? Please write below.

Liability:

I understand that the pilgrimage leaders from Ananda Sangha Trust are acting as the tour coordinators only. They are not responsible for any inconvenience or errors caused by our service providers, such as airlines, Indian railways, the resort, and other tour guides, traffic delays, etc. They are not responsible for any loss of personal property, injury, or accidents during the pilgrimage.

I have read and understand the terms and conditions stated.

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