ayuryogakannur@gmail.com

+91 9947 271514

Application Form
Note: This is a formal application form for those interested in joining the program. If you are only making an informal enquiry, then please use the contact form instead.
  • Personal Details
  • Health Information

Personal Details

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Health Information

The following questions are here to help us to provide each participant with the nessesary means to make the program more beneficiable. The answer to these questions will be kept in strict confidance

Are you currently taking medicines for any physical or psychological conditions
Do you have any chronic physical limitations or disabilities
Do you have a communicable disease
Have you had a serious illness or major surgery within the last five year
Are you currently pregnant or trying for pregnancy
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You are required to pay a registration deposit to reserve your space.The balance fee should be paid upon arrival or before check out. We accept the initial Course Fee Registration deposit through Credit Cards, Paypal or Bank (wire) Transfers.

Payment Option