Card No.: ________________ SHIVYOG Advanced Prati Prasav Sadhna (In English) By Acharya Ishan Shivanandji 18 Feb – 21 Feb, 2015 Venue: Shree Lakshmi Narayan Mandir, Kg. Kasipillay, Kuala Lumpur SEATING 1. Collection of Entry Tags 2. Advanced Prati Prasav Sadhna Time Date 2 - 4 pm 17 Feb 9am – 5 pm Front Normal 18 - 21 Feb Kindly state your seating preference (subject to availability) chair floor KINDLY REGISTER EARLY AS SEATS ARE LIMITED. REGISTRATION WILL CLOSE ONCE FULL. Name: ____________________________________________________________________ Male Female City: _______________________________ Mobile: __________________ Home Tel:__________________ Email: ______________________________ Are you attending Shivyog shivir for the first time ? Yes No Declaration I am participating in the Shivyog programs at my own will. I take full responsibility for participating in this program, its outcome whatsoever. I will maintain the sanctity of the program and keep the proceedings of the program confidential. I will maintain the discipline during the program and I understand that if my conduct is found to be inappropriate, I would be asked to vacate the premises and I will be refused admission in the program. I am atleast 12 years of age. Recording of the program content by any device or mode is strictly prohibited. Anyone found doing so will be asked to leave the venue and his registration will be cancelled. Date: _____________ Signature: ________________________ Registration starts from 10 Jan, 2015 at the following venues : Shree Lakshmi Narayan Temple, Kampong Kasipillay, K.L. Shivyog Centre, Petaling Jaya. Every Sunday (Saturdays 10 Jan, 24 Jan & 7 Feb only) 10.30 am – 12.00 noon 4.00 pm – 5.00 pm st (A-1-6, 1 Floor, Block A, Avenue 8, Jalan Sungai Jernih 8/1, 46050 Petaling Jaya.) Registration forms can also be downloaded from www.shivyog.com/malaysia Persatuan Meditasi Shivyog KL & Selangor, c/o No. 9, Jalan Tuanku Abdul Rahman, 50100 Kuala Lumpur For enquiries, call Tel.: 013-999 9992, 017-666 6602, 012-683 2644 Or Email: shivyogmalaysia@yahoo.com or malaysiashivyog@gmail.com