Silent Retreats form

Name

Picture

Email ID

Education

Age

Address

Contact Number

Occupation

Favorite color

What is one thing that nature has taught you?

Majority of your day time is spent in?

What is one thing in you that inspires people around you?

How do you spend time alone?

If you could wake up tomorrow having gained any one quality or ability, what would it be?

What’s that makes you sad?

Are you on any medication or drugs, please specify?

Have you attended any meditation / spiritual retreat before, please specify?

During the last 3 months, have you often been bothered, feeling down, depressed or hopeless?

Reference (Specify Name with Proper Detail)

What is most important of the five senses to you?

The activity that you would want to do more in your day and you think don’t have time for, and why?

Do you enjoy your own company?

What’s that makes you most happy?

Are you unhappy with the quality of your life and what would you want to change to make it better?

For what in your life do you feel most grateful?

What is that you are expecting from this retreat?

Do you usually feel you can manage all the tasks required of you in a given day?

List in order - Hope, Faith, Justice, Trust, Gratitude - when taking on a new endeavor?

Would you like to bring any friends or family? Please add their details: Contact details, Aadhaar card, Email & Phone.

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