* First Name
* City State / Zip
* Last Name
Special Skills / Hobbies:
* Date of Birth(dd/mm/yyyy):
* Phone Number:
* Permanent Address:
How did you hear about the course of Isthaa International Spa Therapy & Ayurveda ?
Have you attended any other Ayurveda/Spa Therapy/Pranic Healing Course? If yes, name of the institution
Are there any specific areas of interest that you would like to explore in this course?
* Have you done Ayurveda/Spa Therapy/Pranic Healing course before?
Why would you like to take this Ayurveda/Spa Therapy/Pranic Healing course?
C: Health Condition
Do you have any injuries or disease?
Do you have any food allergies, medication, or any other issues related to health?
D: Additional Inquiries
Any additional comments or questions?
Cozy Nook North-Palolem beach,
On the River Bank,Canacona,
Ph: +91 8951 983 661
+91 9481 777 000
We're not around right now. But you can send us an email and we'll get back to you, asap.
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