Registration Form

* Name :

* Present Occupation :

* Designation :

* Father’s/Husband's Name :

* Age :

Years

* Permanent Address :

* Total No. of Participants including yourself :

Accommodation required (kindly select the relevant block below ) :

* Date of Arrival :

* Date of Departure :

* Room Type:

Single

No. of Rooms Required :

Rate (per person):

Total :

Twin(Sharing)

No. of Rooms Required :

Rate (per person):

Total :

For Ujjain, Omkareshwar, Indore Visit (Optional) :

No. Of Persons :

Rate (per person):

Total :

For Learning TM :

No. Of Persons :

Rate (per person):

Total :

* Grand Total :

* Mobile Number :

Landline No :

* E-mail Address :

* WhatsApp No :

* Mobile number for contact in case of emergency :

* Enter Transaction ID :

* Kindly bring the bank receipt or screen shot of the bank transaction with you and submit it at the reception counter on your arrival.