Reservation PERSONAL INFORMATION * Name : Mr Ms Mrs Age : * Email : Nationality : Passport No : Postal Address : Pin : CONTACT PHONE NUMBERS Residence : Residence : Mobile : Mobile : COURSE SELECTION FULL TIME COURSES PERIOD Ayurvedic Massage & Panchakarma Therapy

(AMPT) - 4 Weeks

----Select Your Course Period---- 4th January to 30th January 2012 1st February to 28th February 2012 1st March to 29th March 2012 1st April to 28th April 2012 May 2012  Not available 2nd June to 30th June 2012 1st July to 30th July 2012 1st August to 29th August 2012 1st September to 29th September 2012 1st October to 29th October 2012 2nd November to 30th November 2012 1st December to 29th December 2012 Ayurvedic Massage & Herbology

(AMH) - 3 Weeks ----Select Your Course Period---- 4th January to 24th January 2012 1st February to 20th February 2012 1st March to 20th March 2012 1st April to 21st April 2012 May 2012  Not available 2nd June to 22nd June 2012 1st July to 21st July 2012 1st August to 21st August 2012 1st September to 21st September 2012 1st October to 21st October 2012 2nd November to 23rd November 2012 1st December to 21st December 2012 Certificate Course on Ayurvedic Bodywork

2 Weeks ----Select Your Course Period---- 4th January to 18th January 2012 1st February to 15th February 2012 1st March to 15th March 2012 1st April to 15th April 2012 May 2012  Not available 2nd June to 16th June 2012 1st July to 15th July 2012 1st August to 15th August 2012 1st September to 15th September 2012 1st October to 15th October 2012 2nd November to 16th November 2012 1st December to 15th December 2012 PART TIME COURSES MONTH Ayurvedic Beauty Therapy

2 Weeks - ( Timing is 4 pm to 7 pm ) ----Select Your Course Period---- 8th January to 22nd January 2012 5th February 2012 to 18th February 2012 5th March to 18th March 2012 7th April to 20th April 2012 May 2012  Not available 8th June to 22nd June 2012 7th July to 21st July 2012 7th August to 21st August 2012 7th September to 21st September 2012 7th October to 21st October 2012 9th November to 23rd November 2012 7th December to 21st December 2012 Ayurvedic Pregnancy Care and Baby Massage

1 Week - ( Timing is 4 pm to 7 pm ) ----Select Your Course Period---- 22nd January to 22nd January 2012 19th February to 26th February 2012 19th March to 26th March 2012 21st April to 28th April 2012 May 2012  Not available 23rd June to 30th June 2012 22nd July to 30th July 2012 22nd August to 30th August 2012 22nd September to 30th September 2012 22nd October to 30th October 2012 24th November to 31st November 2012 22nd December to 30th December 2012 Teachers Trainging Program on Advanced Yoga Therapy - 4 Weeks ----Select Your Course Period---- 4th January to 30th January 2012 1st February to 28th February 2012 1st March to 29th March 2012 1st April to 28th April 2012 May 2012  Not available 2nd June to 30th June 2012 1st July to 30th July 2012 1st August to 29th August 2012 1st September to 29th September 2012 1st October to 29th October 2012 2nd November to 30th November 2012 1st December to 29th December 2012 Certificate Course on Yoga and Meditation

4 Weeks ----Select Your Course Period---- 4th January to 30th January 2012 1st February to 28th February 2012 1st March to 29th March 2012 1st April to 28th April 2012 May 2012  Not available 2nd June to 30th June 2012 1st July to 30th July 2012 1st August to 29th August 2012 1st September to 29th September 2012 1st October 2012  to 29th October 2012 2nd November to 30th November 2012 1st December to 29th December 2012 ACCOMMODATION OPTIONS ROOM TYPE OCCUPANCY Deluxe room with A/C ans Sea View

--Select Room-- Single Room Double Room Cottage type room with A/C and Sea View

--Select Room-- Single Room Double Room Standard A/C room with seaview

--Select Room-- Single Room Double Room Non A/C room with Seaview

--Select Room-- Single Room Double Room Non A/C room with out Seaview --Select Room-- Single Room Double Room Furnished Appartment with Cooking facility

--Select Room-- Single Room Full Appartment * Message : Arrival date : Arrival time : Departure date: Arriving from : Number of persons :

School of Ayurveda and Panjakarma

Mascot Beach Resort

Near Baby Beach, Burnassery

Kannur (District) , Kerala (State)

South India - 670013

24 hour helpline +91 98952 68511

Fax: 91 497 2705862 Email: info@ayurvedacollege.net

ayurveda_doctors@hotmail.com

