First Initiation Application

First Initiation Application for initiation candidates of His Holiness Bhakti Charu Swami

 Before completing this form, read the information at www.bhakticharuswami.com/initiation carefully.

 Complete this form in proper case (not UPPER CASE). Ideally, it should be completed electronically and emailed, but it can also be printed and completed in writing, then scanned and emailed.

 All fields are mandatory except those marked #, which are optional.

Did you previously Yes / No When you requested shelter, you may have complete the Shelter completed that form. Request Form? → First Name ↓ Middle Names (if any) ↓ # Last Name ↓

Salutation ↓ Marital Status Gender ↓ Mr. / Miss. / Ms. / Mrs. / Male / Female Dr. / Prof. / Other (enter) Date of Birth Enter your date of birth in dd-mm-yyyy format. Marital Status Single / In a relationship / Engaged / Select one option and delete the others. Married / Widowed / Separated / Divorced Ashram Brahmacharya, Grihastha, Select one option and delete the others. Vanaprastha Nationality If you have more than one nationality, enter all of them. Ethnic Origin Asian – Chinese / Asian – Indian / Select one option and delete the others. Asian – Other / Asian - Pakistani/Bangladeshi / Black – African / Black – Carribean / Black – Other / Latino/Hispanic / Mixed Race – Other / Mixed Race - White and Asian / Mixed Race - White and Black / White – Caucasian / White – Other / Other Languages Enter the languages that you are fluent in, starting with your native language. Spouse Name # Enter name of husband or wife e.g. Amit Patel. If spouse is initiated, enter initiated name, suffix guru's initials and enter the legal name in parenthesis e.g. Damodar Das BCS (Amit Jain); Radharani Devi Dasi JPS (Anita Patel). Suffix with "(Late)" if he/she has left body. Father Name Same format as above.

Mother Name Same format as above.

Sons/Daughters # Separate multiple entries using commas. If

of 3 children are adults, same format as above. Else just enter first names. Mobile Number Enter your mobile number with country code e.g. +91 91234 56789. Home Phone # Enter your home number with country code e.g. +91 91234 56789. Other Phone # Enter your work or alternate number with country code e.g. +91 91234 56789. Email Address Enter a personal email address

Email Alternative # Enter an alternative or work email address

Facebook Profile # e.g. www.facebook.com/firstnamelastname

LinkedIn Profile # e.g. www.linkedin.com/profile/view? id=000108 Skype ID # e.g. firstnamelastname

Address Enter you full residential address below. Line 1

Line 2

Line 3

State / Province ↓ Postal Code ↓ Country ↓

Occupation Private Company / Government / Selection one option and delete the others. Public Sector / Own Business / Self Employed / Full Time Seva / Homemaker / Retired / Student / Not Working Company If employed, enter the name of the employer. If studying, enter name of college. If retired or homemaker, leave blank. Title Enter work designation e.g. Director, Software Engineer, Chartered Accountant, Doctor, Undergraduate Student etc. Education Bachelors / Masters / Doctorate / Select the highest educational level Diploma / Undergraduate / achieved and delete the others. Associates Degree / Honours Degree / Trade School / High School Colleges Attended Enter the names of all colleges attended e.g. Delhi University. Academic Qualification Enter degree names e.g. BA History, LLM, MBA, MBBS, PhD Mathematics etc. Page 2 of 3 Seva Describe any seva you are currently doing e.g. Doing: book distribution, temple cleaning, donating etc. Also enter any seva that you would like to do for Guru Maharaj e.g. Interested to do: transcription of lectures etc. Local ISKCON Temple State the name of your local ISKCON centre (temple/nama-hatta). Spiritual Authority State the name of the devotee in your local ISKCON centre who is your current spiritual authority. Recommender State the name of the temple president or yatra leader who is writing the recommendation letter for you. Recommender Mobile Enter the mobile number of the devotee Number recommending you, with country code e.g. +91 91234 56789.

Any other Information Please state any other information you wish us to know

By submitting this form, I declare that I have read, fully understood and am complying with the requirements for first initiation as per ISKCON Law, including completion of the one year preparatory period (chanted Srila Prabhupada’s pranam-mantra for six months, taken the shelter examination, requested and received shelter from Guru Maharaj, aspired to Guru Maharaj for at least six months).

If you are completing the form electronically, you may type your full name in the signature field and printing is not required.

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