Register

REGISTRATION FORM

WORKSHOP: FAMILY / SYSTEMIC CONSTELLATION
Date: 03-Feb-2023 (Fri) and 03-Feb-2023 (Fri) at Bangalore

Name
Age	years	Date of Birth
Gender	Male Female
Occupation
Address
Telephone (H)		Mobile
E-mail ID
Your personal details will be kept confidential Please be authentic, honest and specific as you answer the following: 1) Briefly describe any challenges you face in your life right now eg. in the area of career, health, family, relationships.
2) Do you have medical problems like, diabetes, heart condition, high blood pressure, frequent headaches etc? If so, identify and state if under medication for the same.
3) Do you have emotional health issues like depression, bipolar, schizophrenia etc. If so, identify and state if under medication for the same.
4) By attending this workshop, I would like ...

I understand that this workshop involves experiential processes and I am willing to participate taking responsibility for myself.
Cancellation & Refunds: After deduction of admin fee of Rs. 300 refunds will be made up to 10 days prior to the workshop. Last minute cancellation deprives other people of a place. Thus for cancellations post 10 days prior to workshop, no refunds will be made unless another person makes up the stipulated number.

For further enquiries, please email spanda.asia@gmail.com

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