Life Member Application – IYA

Title *

Sri / Smt / Ms

Name *

First

Middle

Last

Email *

Mobile Number *

Gender *

Date of birth *

Father's Name *

Mother's name *

Institute's name *

Candidate's address *

Candidate's Country *

Candidate's State *

Candidate's AADHAR Number *

Candidate's Photo *

Candidate's ID Proof (Government ID / Photo ID) *

Certificate *

Certificate/Diploma/Degree/Master Degree/PhD in Yoga

Comment or Message

Mandatory Declarations *

I confirm that the information given in this form is true, complete and accurate
I have read and agree to abide by the IYA Code of conduct and ethics