Application Form for Kirtan Course

Package 6 - Apartment, bedroom, kitchen with dinning room, bathroom - 1885€

Your Name*

E-mail*

Date of Birth*

Gender*
MaleFemale
Skype

WhatsApp

Address*

Telephone*

Marital status*
SingleMarriedDivorced
Where did you hear about the Bhaktivedanta College Radhadesh Kirtan Course?*



Health information

Do you currently have any physical health problems?*
YesNo

Have you had any mental or emotional health problems? *
YesNo

Do you currently have any mental or emotional health problems? *
YesNo

Do you regularly take any medication? *
YesNo

Criminal / Abuse screening

Have you even been convicted of a criminal offence?*
YesNo

Have you ever been convicted on any domestic violence charges?*
YesNo

Were you a victim of abuse or molestation while a minor?*
YesNo

Have you ever been accused of abusing a child?*
YesNo


References*:

Self-evaluation

Please evaluate your level of knowledge and expertise of:

Karatals*Almost zeroSomethingPretty averageVery goodExpert
Harmonium*Almost zeroSomethingPretty averageVery goodExpert
Mridanga*Almost zeroSomethingPretty averageVery goodExpert
Singing*Almost zeroSomethingPretty averageVery goodExpert


What challenges (if any) do you anticipate during the Kirtan Course?

Dietary limitations:

I will need transportation from the airport/train station:*

In case of "YES" we will contact you shortly before the event to arrange for your pickup. Departure arrangements will be organized before the end of the Kirtan Course.
YesNo

I want to buy a mridanga. (A mrdanga of your choice available amongst those owned by the Kirtan Course):*
Yes (250€)No

Deposit money will be send by:
Bank wireTransferWisePayPal

Rest of the money will be given by:
Bank wireTransferWiseCash

After we receive your registration email you will be asked to pay a non-refundable booking/security deposit of 450 EUR. Only after we receive your deposit payment booking is confirmed.
Registration confirmation