Ayurveda/Research Methodology Registration Form

Name:

Mailing Address:

Please select the course/courses you want to enroll
 Introduction to Ayurveda
 Research Methodology

Phone Number:

Alternate Phone Number:

Email ID:

Skype Id (Optional) :

Educational Details::

Institution Location Degree/Diploma/Certificate Obtained

Motivation for enrolling in the Hindu Program::

Other Concerns or Comments:

Dated Signature of Student:
(Please print in your name and current date)

Payment via check: 
Please mail in a check payable to "Hindu University of America" for the amount of $300 for one course and $600 for both the courses. The mailing address for the check is:
Mr. Satya Gupta,
Hindu University of America - South Florida Center
5340 North Federal Highway, Suite 104, Lighthouse Point, FL-33064
Please do mention your name on the check.
OR
Online Payment: