Registration Form

* Name :

* Present Occupation :

* Designation :

* Age :

Years

* Father’s/Husband's Name :

* Permanent Address :

* Nationality: Indian International

* 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 :

Visit to Mahakal Jyotirlinga Ujjain (Optional) :

No. Of Persons :

Rate (per person):

Total :

Fee for Learning TM :

No. Of Persons :

Rate (per person):

Total :

Vedic Divine Technique : YesNo

Vedic Divine Technique Fee :

No. Of Persons :

Rate (per person):

Total :

Are You A Member Of Maharishi Organistion : Yes No

Student Discount 20%

* Grand Total :

Are You Student of MVM School : YesNo

* Student Name :

* Student Class :

* Teacher Name :

* Teacher Mobile Number :

* Mobile Number :

Landline No :

* E-mail Address :

* WhatsApp No :

* Mobile number for contact in case of emergency :

Account Name	Maharishi Bliss Residency
Account Number	25920200000252
Bank	Bank of Baroda
Branch	Lambakheda, Bhopal
IFS Code	BARB0ISLBHO

* 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.