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Jai Baba Swami -Special Application Form For Samarpan Vivah (For Ambareesh)

Personal Details: Name Father Name Surname Recent Photograph

Current Address

Mobile No.

Resident No/Landline No.


Birth(Details) Age Date: Time: Place:

Mother Tongue Other Languages Known Height Weight Complexion Religion Caste Blood Group Educational Qualification Occupation Annual Income Rs.
About Me Engaged prior? Medical History (if any) Hobbies

Family Background:

Family Address

Mothers Name Details Fathers Name Details Details of brother/sisters


Education Occupation
(Present/Before retiring)

Education

Occupation
(Present/Before retiring)

(Qualification, present job if any, Marital Status)

Annual Income Family Details of property owned by family

Details of Vehicles owned by family

History of any hereditary illness

Which shibir led you to Samarpan meditation?


(Date and Place of Shibir)

Which meditation center are you attached to? How many times do you meditate in a week? Who else in your family is engaged in Samarpan Meditation? Future Plans (General)

At Home At Center

Professional What is your Goal in Life? Are you planning to shift your address? Spiritual

Your expectations about your partner

Signature Signature (Mother)& Mobile No Signature (Father)& Mobile No Signature (Center Acharya)& Mobile No

If Non Sadhak Please Give Reference Name and Contact no of Sadhak

Samarpan Mediation Details:

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