Wellness

State

District

Place

Name (As per Aadhar)*

Date of Birth *

Father's name *

Mobile No *

Aadhar no*

Email Id *

10th Pass(Year) *

12th Pass(Year) *

Height

Weight

Current Activity/ Profession

No. of Family Members dependant on You

Currently on-Going Studies(if any)

Previous Experince on Panchalkarma Therapies

Planning to Learn Panchkarma to Join any Organisation as Therapist/ Start Own Panchkarma Center

If you wish to start your own business, will be able to invest/ looking for financial help from Patanjali

Any Person known to you working with Patanjali Group

How much you wish to earn per month from Therapies ?

Owns a Android Phone/ iPhone

How much monthly earning you have currently ?

How many hours you can devote every day for training ?

What is the ideal time slot for you to attend the training ?

Morning-6AM to 8AM/Evening-7PM to 9PM

Day-9AM to 5Pm

Will be able to come to Local/ Central Patanjali Training Facility for Training, as & when required ?

Will be able to read, write and speak English

After training you will have any joining location preference

Are any Friends/Family Members working with any Panchkarma/ Wellness Center ?

Any difficulties or concerns you have ? (Physical/ Otherwise)

Registration Form for therapist training program