Kundalini Program Application

PERSONAL DETAILS

First Name

Family Name

Gender

Male Female

Country

Phone

Date of birth

Birth Time

Birth place (City, Country)

YOGA EXPERIENCE

How many months have you been practicing Yoga?

If accepted into the Kundalini Program, how many Agama levels will you have completed by then?

Describe your current personal/home yoga practice:

IN-DEPTH

What is your motivation for applying to the Agama Kundalini Program?

As a student, what is your relationship with Agama and how do you see your long-term involvement in the school?

FULL DISCLOSURE

In order to make informed decisions, the teachers and staff at Agama must be able to rely on the truthfulness of
information provided by applicants. The information an applicant provides on this form is treated as confidential
and will only be seen by those teachers and staff involved with the Kundalini Program.

Note: Before applying for the Agama Kundalini Program, please take into consideration that you will have to completely renounce smoking and the use of recreational drugs before starting and during the entire duration of the program. Non-compliance with this requirement may provide grounds for expulsion from the program.

“By checking the signature box and typing my full name below, I affirm that the information provided on this application form is true and complete to the best of my knowledge. False, incomplete, or misleading information is grounds for rejection of this application, expulsion from the program, or revocation of certification after completion of the program."

By checking this box, I indicate my signature as verification of the statement above.

Print Full First Name / Family Name

Date

I have read and accept Terms & conditions

AGAMA KUNDALINI PROGRAM APPLICATION FORM

Application for Admission

PERSONAL DETAILS

YOGA EXPERIENCE

HEALTH INFORMATION

IN-DEPTH

FULL DISCLOSURE

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