APPLICATION FORM

YOGA CHAKRA EXPERIENCE

Recent Photo
Bihar School of Yoga 2024
Ganga Darshan
Munger
Bihar 811201, India

Please fill in this application form in CAPITAL LETTERS using black ink. All personal information disclosed
here will be treated confidentially. The date for receiving applications with all annexure closes 1 month
prior to commencement of the training. Late and incomplete applications will not be accepted.
All participants are expected to abide by the rules of the ashram, maintain the discipline and also
participate in the daily activities and seva. Admission policy is selective and a personal introduction is
preferred when accepting applications. Bihar School of Yoga reserves the right of admission to any
training, program or event.
The training being applied for is:
Tick TRAINING (for national and overseas applicants) DATE
Yoga Chakra Experience 11th February to 11th July 2024
Yoga Chakra Experience 18th July 2024 to 18th January 2025

Please note: This is NOT a Teachers’ Training Course. No certificate will be given by the end of the training.
For nationals only:
I enclose herewith the advance remittance of Rs. 5,000/- in favour of Bihar School of Yoga, Munger,
payable at Munger as application fee for processing the application, which I understand is non-refundable
and non-transferable.

Demand draft No. ____________________ Dated: ________________________ Bank: _____________________

FOR OFFICE USE ONLY

Application form received on: ............................................... By: post / hand / other along with:
2 Photos (affixed to form) Aadhaar card (national) Passport copy (overseas)

Curriculum Vitae (CV) List of current medications Medical report

Declaration by applicant

Other: ……………………………………………………………………………………………………………………………………………………………………
Admission letter sent on: ………………………………………………………… By: post / hand / other ………………………………………
For nationals:
Application fee: Rs. 5,000/- received: Yes Receipt no. ........................................ Date: …………………………………

2024 Yoga Chakra Experience App Form Page 1

 APPLICATION FORM
YOGA CHAKRA EXPERIENCE
Bihar School of Yoga 2024
Ganga Darshan
Munger
Bihar 811201, India

PERSONAL INFORMATION

1. Full name: ...............................................................................................................

2. Spiritual name (if any): ............................................................................................
3. Diksha: Mantra / Jignasu / Karma / Poorna (circle one) Given by: .............................................................
4. Sex: Male Female
5. Age in years: Date of birth: Day Month Year
6. Marital status: Married Unmarried
7. Name and age of husband/wife; name/s and age/s of children, if any: .............................................................
…………………………………………………………………………………………………………................................................................
……………………………………………………………………………………………………………………………………………………………………….

8. Permanent address: ............................................................................................................................................

......................................................................................................................................................... ………………….
................................................................................. Pin/Zip ..............................................................................
9. Full Postal address (if different from permanent address): ........................................................... ………………….
......................................................................................................................................................... ….………………
.................................................................................. Pin/Zip ..............................................................................
10. Your email ID: ....................................................................... Website: .................................................................
11. Phone number: Mobile: ............................................ Home: ............................... Work: .................................
12. Family contacts: Father: ............................................ Mother: ............................. Other: ................................
13. How are you connected to Satyananda Yoga, or were you referred by someone? Give details:
............................................................................................................................................................................
............................................................................................................................................................................
14. In case of emergency, please contact: Name: ………………………………………………… ............................ ………………..
Relation: ……………………………………….....Phone: ………………………………………………………………………………………………
Email: …………………………………………………………………………………………………………………………………………………………...

PERSONAL IDENTIFICATION

15. Present nationality: .......................................... Nationality at birth: ..................................................................

16. Birthplace: City: ..................... State: ................................... Country: ..............................................................

2024 Yoga Chakra Experience App Form Page 2

 APPLICATION FORM
YOGA CHAKRA EXPERIENCE
Bihar School of Yoga 2024
Ganga Darshan
Munger
Bihar 811201, India

17. Facebook ID: ........................................................ Twitter ID: ..............................................................................

18. Drivers license no.: .................................................. valid until: ..........................................................................
19. For nationals: Aadhaar Card: ......................................................
For Overseas applicants: Passport no. ……………………………………………. Valid until:…………………………………………….

20. Native language: ..................................................................................................................................................

21. English proficiency: Fluent Average Poor
22. Spoken languages and level of proficiency: …………………………………………………………………………………………………...

EMPLOYMENT & PROFESSION

23. Professional qualifications: .................................................................................................................................

………………………………………………………………………………………………………………………………………………….. ....................
24. Present occupation/profession: ..........................................................................................................................
Company name and address: ………….. ................................................................................................................
………………………………………………………………………………………………………………………………………………… ......................
Name of reference: …………………………………………………. Position: …………….…………………………………… ..................
Contact number: ……………………………………………………… Email: …………………………………………………….. ..................

ASHRAM EXPERIENCE
25. Have you stayed at Munger ashram before? Y / N If yes, list periods of ashram experience:

Year ................... Duration ................................ Purpose ........................................................................

Year ................... Duration ................................ Purpose ........................................................................

Year ................... Duration ................................ Purpose ........................................................................

26. Have you visited any other ashram? Y / N If yes, give details:
Year Ashram name, location Duration of stay Activity/involvement
.............. .................................................. ........................................ ................................................
.............. .................................................. ........................................ ................................................

2024 Yoga Chakra Experience App Form Page 3

 APPLICATION FORM
YOGA CHAKRA EXPERIENCE
Bihar School of Yoga 2024
Ganga Darshan
Munger
Bihar 811201, India

YOGA EXPERIENCE

27. Do you have experience in yoga teaching? Yes / No If yes, as:

Yoga Teacher Yoga Consultant Yoga Therapist

a) Give details: .....................................................................................................................................................

.............................................................................................................................................................................
.............................................................................................................................................................................
b) Place of teaching (home, ashram, hospital, school, etc.): ...............................................................................
c) Duration: .........................................................................................................................................................
d) Location (city, town, village): ..........................................................................................................................
e) Country: ..........................................................................................................................................................
f) Name and contact details of a person as reference: .......................................................................................
.............................................................................................................................................................................

28. List the major books on yoga, sannyasa and spiritual life you have read: .........................................................
.............................................................................................................................................................................
.............................................................................................................................................................................

29. Have you written any papers, articles and/or books on yoga or related topics? Yes / No
If yes, provide details: .........................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
30. Propagation (conducted / organised / participated), please list (give details on a separate sheet if required):
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................
a) Yoga camps: ..................................................................................................................................................
b) Lectures/seminars on yoga: .........................................................................................................................
c) Sadhana programs: .......................................................................................................................................

31. What is the aim of your yoga practice (physical health / mental wellbeing / concentration / emotional
wellbeing / psychic / spiritual / other)? .............................................................................................................

...........................................................................................................................................................................

2024 Yoga Chakra Experience App Form Page 4

 APPLICATION FORM
YOGA CHAKRA EXPERIENCE
Bihar School of Yoga 2024
Ganga Darshan
Munger
Bihar 811201, India

SOCIAL ACTIVITIES
32. List your main hobbies and skills: ......................................................................................................................
...........................................................................................................................................................................
33. Do you prefer solitude or the company of others? ...........................................................................................

34. Are you active in public life in any capacity? Y / N If yes, give details: ............................................................
...........................................................................................................................................................................
35. Are you or any member of your family related to any political or religious organizations? Y / N
If yes, give details: ..............................................................................................................................................

...........................................................................................................................................................................
36. Have you ever been prosecuted for any criminal offence? Y / N If yes, give full details of offence committed
and sentence undergone: .................................................................................................................................
...........................................................................................................................................................................
...........................................................................................................................................................................
37. Are you willing to participate in the ashram activities wholeheartedly? Y / N
38. List the skills you have to assist with ashram activities (driving / gardening / electrical / musical / IT /
computer, etc.): ..........................................................................................................................................
...........................................................................................................................................................................

39. My reason and intention for participating in the training is: ..............................................................................

………………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………………

LIFESTYLE

40. List any form of exercise that you do during the week: ...................................................................................
...........................................................................................................................................................................
41. How many days of the week do you exercise? ...............................
42. Frequency of yoga asana, pranayama practice: ............................. days per week.
43. Frequency of yoga nidra practice: ........................ days per week.

44. Frequency of mantra practice:............................ days per week.

45. How many hours per day do you work professionally?.......................... Hours.
46. How many hours per night do you sleep? .............................. Hours.

2024 Yoga Chakra Experience App Form Page 5

 APPLICATION FORM
YOGA CHAKRA EXPERIENCE
Bihar School of Yoga 2024
Ganga Darshan
Munger
Bihar 811201, India

47. How many days of the week do you eat non-vegetarian food? ............................................................................
48. List any habits, such as alcohol, drugs, smoking, tea, coffee, etc...........................................................................
................................................................................................................................................................................
49. Do you have any dietary restrictions? Y / N If yes, give details: .......................................................................
................................................................................................................................................................................

MEDICAL DETAILS
50. Are you taking any medication/s at present? Y / N If yes, give name and for what condition:
a) ........................................................................................................................................................................
b) ........................................................................................................................................................................
c) ........................................................................................................................................................................
51. If you have any current physical health problems, allergies, illnesses or diseases, give full details on a SEPARATE
SHEET; including medication being taken, restrictions in and management of the condition, and provide below
the contact details and phone number of your doctor in the case of an emergency:

...........................................................................................................................................................................

52. Have you suffered from any major illness in the past? Y / N If yes, give details:
a) ........................................................................................................................................................................
b) ........................................................................................................................................................................
c) ........................................................................................................................................................................
53. Do you have a history of any mental health issues, i.e. anxiety, panic attacks, depression, etc.? Y/N
If yes, give details of symptoms, duration, treatment and present condition:
...........................................................................................................................................................................

...........................................................................................................................................................................

...........................................................................................................................................................................

54. If you have any current mental or emotional health issues please give full details on a SEPARATE SHEET;
including medication being taken, restrictions in management of the issue, and provide below the contact
details and phone number of your doctor in the case of an emergency.

...........................................................................................................................................................................

55. Have you ever been tested positive for Covid-19? Yes / No.
If Yes, please specify date (month / year): ……………………………………………………………………………………………………

2024 Yoga Chakra Experience App Form Page 6

 APPLICATION FORM
YOGA CHAKRA EXPERIENCE Recent Photo
Bihar School of Yoga 2024
Ganga Darshan
Munger
Bihar 811201, India

DECLARATION BY THE APPLICANT

1. I, the undersigned, declare that the information given in this application is true, complete and accurate to
the best of my knowledge.
2. I understand that if during the interview and admission procedure it is found that the information given in
this form is incorrect, I will not be eligible.
3. I understand that proficiency in Hindi / English language is required. If during the interview and admission
procedure my Hindi / English is found to be insufficient I will not be eligible.
4. I further declare that there are no criminal or civil litigation or charges against me.
5. I am solely responsible for my health, welfare and medication while I undergo yoga training in the campus.
6. I am of sound physical, mental and emotional health. If found to be not in good health, I will leave the
training and campus for proper medical care.
7. In case of any emergency or unforeseen medical situation or treatment, all expenses will be borne by me
and I will not hold Bihar School of Yoga liable in any regard in relation to the same.
8. I will contribute to and participate in all the activities of the ashram wholeheartedly in the spirit of nishkama
seva (service without personal motive).
9. During my stay I will lead a life of sanyam (restraint in thought, word and deed), sahayoga (willing
cooperation) and shanti (harmony & peace) and follow all the rules of Bihar School of Yoga, Ganga Darshan
Campus.
10. If I am not able to follow the above, and/or the Administration asks me to leave, I agree to do so at the
earliest.

Signed .................................................................. Date.................................................

Checklist of documents to enclose with this application:

2 current passport-size photos (affixed to form)
Photocopy of Aadhaar card (national applicant)
Photocopy of passport (overseas applicant)
Medical details (including Medical Report or Medical Fitness Certificate) if applicable
Copy of CV
For national applicant:
Application fee for processing the application by demand draft no. ................................... for Rs.5,000/-
Self-addressed, stamped envelope for Registered Post

2024 Yoga Chakra Experience App Form Page 7