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Neti Advisor Enrollment Form


If you are interested in helping people seeking to learn Neti in your city then, please spare a moment to fill the following form.

 

 
Contact Details
Would you like your contact # to be passed to the customer / prospective student in your area seeking this specific service Yes No
 Name :
 Street Address :
 City :
 State / Province :
 Zip/ Postal Code :
 Phone :
 Your e-Mail ID :
 Any preferable time to
 Contact :
DETAILS RELATING TO NETI SERVICE
Stages of Neti that you are comfortable to instruct: (check relevant boxes)
  Stage 1 (water in - one nostril; water out - other nostril)
  Stage 2 (water in - nostril; water out - mouth)
  Stage 3 (water in - mouth; water out - nostril)
Experience of doing Neti:
  Less than 1 year More than 1 year  
Would you also like to offer sale of Neti pots to your students?
  Yes No
    If yes, please enter charges desired:
 
 

 
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