University of Patanjali Haridwar, India

(Established by the Uttaranchal State Legislature under the

University of Patanjali Act No. 4, year 2006)
Department of Yoga Research
First International Conference on Yoga for Health and Social Transformation
January 2, 2011 to January 5, 2011
(Please fill the form in Capital letters)
1. Prof./Dr./ Mr./ Ms.
2. Institution/University
3. Designation.
4. Specialization.
5. Address (with postal code)


6. Tel: Fax.
Mobile E m a i l .
7. I will be attending the conference to present a paper: (YES/NO)
8. I wish to have accommodation: (YES/NO)
9. Please find enclosed herewith a DD No. Dated

for Rs. drawn in favor of Patanjali Yogpeeth, (Trust).

10. Are you registering as a student: (YES/NO), if yes please provide student ID issued by College/ University

Date (Signature of the Applicant)

For Office use only

Reg. No. Name

Place

Accomodation: YES/NO

Date (Signature)
Note: Please send the scanned copy of the filled registration form, DD/pay-in-slip to: pyp.conference2011@gmail.com
and post the hard copy to: Mr. Nilkamal Singh, (Cell Phone : +91 9897963254) Department of Yoga Research, Patanjali
Yogpeeth, Maharishi Dayanand Gram, Delhi-Haridwar Highway, Near Bahadarabad, Haridwar-249402, Uttarakhand, India.

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