Welcome to Our Ayurveda Integration Program

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Name:

 
Address:

 
Telephone Number:

 
Email Address:

 
Occupation:

 
Goals for joining our program including how you plan to integrate Ayurveda into your personal and/or professional life:

 
Please describe your background with Ayurveda, Yoga and/or Meditation.

 
Date of Birth:

 
Signing up with Full Payment or Payment Plan. Please take note payment plan is an additional $200.


 
I have read the full description of this course and the cancelation policy on The Ayurvedic Center's website and understand these terms and conditions. I fully understand that there are no refunds after November 1, 2017 and once application is approved, that there is a non-refundable $500 application fee. This application fee is applied to the cost of the program. Answering yes below indicates your acknowledgement of the above and takes place of your signature.

     
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