First Name and Surname:

Adress:

Phone Number:

Cellphone:

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Date of Birth:

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Experience with Seminars:

I know about your courses from:
... the Internet my friends Leaflet newspapers a book about tantra television Other Other… please, specify.:

Number of persons:

Specify the number of persons if your want to come in a group or a pair. Each person has to send his/her own application form.

Specify payment (postal order, cash, bank transfer etc.):

Your comments (Anything you want to tell us or ask about):

Yes, my application is binding.

I have read conditions for the workshop and I agree with them.