BRAHMANANDA SARASWATI JYOTISH FOUNDATION Phone: +1 (312) 233-2889 • Fax: +1 (888) 496-8393 • Email: [email protected] M A H A R I S H I J YO T I S H S E R V I C E S A P P L I C AT I O N F O R M M A H A R I S H I YA G YA R E C O M M E N D AT I O N PART 1: RECIPIENT INFORMATION (Please provide information about the individual or organization.) £ Mr. £ Mrs. £ Ms. First Name Family Name The information below is for: £ Myself £ Does not Practice TM £ TM Practitioner Recipient is in good health £ Yes Birthdate: £ Mother Day £ Father £ Sidha £ Wife £ Son £ Daughter £ Governor £ Other: £ No If no, please explain: Month Year Fill in time per example: Exact Birth Time: Hours Minutes Seconds (if known) 8:45 PM = 2 0 4 5 Source of birth time information: Mother, birth certificate, hospital, corrected birth time, etc. Accurate birth place: Please provide the current name of your birthplace. In case the name has changed since your birth, please provide the former name also in brackets. Town (birthplace) Population State/Province Country If birthplace is less than 10,000 population, fill in below: Nearest town of 10,000 population: Distance and direction of above town to birthplace: £ I have already completed a Comprehensive Birth Chart £ I have not already completed a Comprehensive Birth Chart Please note that all information will be kept strictly confidential by Brahmanananda Saraswati Jyotish Foundation CONTINUES NEXT PAGE MYREC 1 BRAHMANANDA SARASWATI JYOTISH FOUNDATION Phone: +1 (312) 233-2889 • Fax: +1 (888) 496-8393 • Email: [email protected] M A H A R I S H I J YO T I S H S E R V I C E S A P P L I C AT I O N F O R M M A H A R I S H I YA G YA R E C O M M E N D AT I O N PART 2: MAHARISHI YAGYA RECOMMENDATION REQUEST Maharishi Yagya Recipient: First Name Family Name I hereby request that Maharishi World Yagya Program suggest possible Maharishi Yagyas for my sponsorship based upon my birthchart information as well as my interest in the following areas. Please mark up to 5 areas of life below. For each area marked a Maharishi Yagya or a combination of Maharishi Yagyas will be recommended. PART3: AREAS OF INTEREST (SELECT UP TO FIVE AREAS) £ Peace of Mind £ Good Memory £ Comforts in Life £ Perfect Health £ Inner and Outer Fulfillment £ Wealth £ Prosperity and Fulfillment £ Family Welfare £ Harmony £ General Happiness £ Removal of Fear £ Conveyances £ Land and Building £ Getting Children £ Fortunate Development of Children £ Removal of Negativity £ Removal of Obstacles £ Winning of Favor in Court Case £ Finding a Suitable Spouse £ Good Married Life £ Fulfilling Relationship £ Ease in Settling an Estate £ Support for Inheritance £ Fulfillment of Desires £ Wisdom and Intelligence £ Spiritual Progress £ Total Knowledge of Vedic Science £ Life in Tune with Natural Law £ Good Luck £ Progress and Success in Activity £ Business £ Favorable Planetary Influences £ Seasonal Yagyas £ Other Area: £ Other Area: PART 4: MAHARISHI YAGYAS YOU HAVE RECENTLY SPONSORED Code/Category Date of Performance Purpose Remarks: CONTINUES NEXT PAGE MYREC 2 BRAHMANANDA SARASWATI JYOTISH FOUNDATION Phone: +1 (312) 233-2889 • Fax: +1 (888) 496-8393 • Email: [email protected] M A H A R I S H I J YO T I S H S E R V I C E S A P P L I C AT I O N F O R M M A H A R I S H I YA G YA R E C O M M E N D AT I O N PART 5: AGREEMENT In placing this request, I understand that the analysis of my birth chart comments only on the trends of the future, according to the principles of Maharishi Jyotish, and does not replace my own responsibility for making decisions. Decision making is, and will always be, my own responsibility. Due to legal reasons it has to be mentioned that the organizer or coordinator of the Maharishi Jyotish consultation, the Maharishi Jyotish Pandit and any other organization involved disclaim any responsibility for consequences resulting from any actions I take based on the analysis of my birth chart. I understand that electronic recording of the consultation is not allowed, whereas I can freely make written notes. I herewith certify that I have understood and answered all questions in this Application for Maharishi Jyotish Consultation truthfully and to my best knowledge. I acknowledge that the geographical data required for the processing of my birth data will be defined according to the sources available to the Maharishi Jyotish Pandit or persons or organizations involved in it. Date: Place: Signature: Name of Guardian (if under 18 years old) Signature of Guardian Please return completed form by email: [email protected] or fax: +1 (888) 496-8393 Please note that all information will be kept strictly confidential by th Brahmanananda Saraswati Jyotish Foundation © Copyright 2015 Brahmananda Saraswati Jyotish Foundation, a non-profit educational organization. All rights reserved. Transcendental Meditation®, TM®, Maharishi Jyotish®, Maharishi Vedic® and Raam Raj SM MYREC 3 are all protected trademarks and used under license or with permission.
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