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Get Vipassana Application Form Pdf

Ply for a place in the course, please complete this form, return it to the above address, and await notification. Please answer all questions fully. This information will be kept strictly confidential. Name: First (Given) Phone: Home ( Last (Family) Work ( ) Gender: M Age: Street Address/P.O. Box ) F Date of Birth: Yr /Mo /Day City State/Province Zip/Postal Code Country Occupation E-mail Address: 1. Check here if you are driving and willing to be conta.

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