Application and Questionnaire
In the Footsteps of the Saints 2012

I would like to participate in the:

_____ Yoga and Ayurveda Retreat in Kerala, 28 January - 9 February, 2012

_____ Pilgrimage Rishikesh, Babaji’s cave and Calcutta from 11 - 25 February, 2012

_____ Puri extension from 25 February - 1 March, 2012

___I wish to join the group flight from _______

Your name, exactly as it appears on your passport:

Date and place of birth:

Passport number:

Place and date of issue:

Date of expiration:

Your current address, street, city, country:

Your legal address, if different from above:

Telephone, fax, mobile phone:

email:

I prefer:

_____double room

_____single room

I wish to share a room with: __________________________________________

If you do not have a roommate, we will try to connect you with another single pilgrim. However, we cannot guarantee finding a suitable roommate for you. If a roommate cannot be found, you will need to pay for single occupancy.

About your contact with Ananda and the teachings of Kriya Yoga

What has inspired you to consider this pilgrimage? Where did you first hear about it?

What are your hopes and expectations?

Are you a Kriyaban or Disciple of the path of Kriya Yoga? If so, when and where did you receive your initiations?

Are you currently practicing:

The Hong-Sau technique? _________

The Energization Exercises? _______

Which of Yogananda’s and Kriyananda’s books have you read?

Have you visited an Ananda center? If so, which ones, when, and what programs did you attend?

Have you been to India before? If so, when and where?

Do you have any physical conditions that we should know about so that we can help you have a good experience during the pilgrimage? (For example, difficulties in walking, in traveling, special dietary requirements, etc.)

Thank you!

INFORMATION ACCORDING TO LAW 196/2003, ART. 13

According to Article 13 of Law 196/2003, we are required to inform you that:

1. Some of the information which we have requested falls into the category of “sensitive data,” which includes information regarding: ethnic and racial origins; religious or philosophical beliefs; political opinions; affiliation to political parties, trade unions or religious philosophical, political or trade-union organizations; personal data concerning health and sexual life.
2. This sensitive data will be used in accordance with the governmental guidelines (Autorizzazione generale del Garante n. 2/2004 ), for the purposes of participation in the social activities organized by Ananda Association, in accordance with its by-laws.
3. This data will be processed by hand and by computer.
4. This data will not be communicated to other parties nor published.
5. We inform you that you are not obliged to give such information, but that refusing to do so could involve partial or total completion of the contract.
6. The entity requesting this information is: Ananda Associazione, Via Montecchio n. 61 – 06025 Nocera Umbra (PG)
7. Ananda Association is responsible for processing this information.
8. You can exercise your legal rights against the Association at any time, according to article 7 of Law 196/2003.

Formula for acquisition of consensus for the treatment of sensitive data

Place ............................. Date ................................

Surname ............................................ Name .................................................................

Having read the information provided by the Association according to article 13 of law 196/2003, and being aware in particular that some of the information requested is regarded as “sensitive” data in Article 4, paragraph 1(d), and Article 26 of Law 196/2003, i.e. “information regarding: ethnic and racial origins; religious or philosophical beliefs; political opinions; affiliation to political parties, trade unions or religious, philosophical , political or trade-union organizations; personal data concerning health and sexual life,” I give my consent to use the data that are necessary for carrying out the operations above indicated.

(legible) signature .......................................................................

Technical organization:
VACANTIONER VIAGGI SNC;

Location and legal address: Via Roma 106, 06083 Bastia Umbra (Perugia) tel.075/8012480
fax. 075/8012466; Filiale: Viale F.lli Briziarelli, 15 06055 Marsciano (PG)
Tel. 075/8742241, fax. 075/8741806.
P.I. 01450570542 - Autorizzazione Regione Umbria 646 17/11/1986 – Responsabilità Civile degli Organizzatori di Viaggio polizza n.24575 Europ Assistance - Iscr. Trib. N. 12801 – CCIAA 140221-WWW.VACANTIONERVIAGGI.COM – info@vacantionerviaggi.com

Obligatory Communication according to article 17 of the law n.38/2006:
"The Italian law punishes with prison prostitution and pornografic acts against minors, also if committed outside of Italy"

Privacy: According to Article 13 of Law 196/2003, we are required to inform you that: The treatments of the personal data in form of paper or digital form is in the full respect of the law 196/03 for the conclusion of the contract and the services provided. The bestowal of the data is necessary. The private data will not be shared, but only communicated with the responsible people for the necessary travel arrangements of the purchased travel package.

For information and reservations:
info@ananda.it   Tel: +39 0742-81.36.20   Fax: +39 0742-81.35.36

Ananda is located in the tranquil hills of Umbria, Italy on “Strada Statale 444” between Assisi and Gualdo Tadino. It is the largest retreat center in Europe for Yogananda’s teachings.

Travel Directions

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Ananda Associazione • Via Montecchio, 61 • I-06025 Nocera Umbra (PG) • ITALY