Your name
Your number(whats app)
Your email Qualifications Date of Birth
Is this the first time you are attending a Self Development Course? YesNo How committed are you towards your personal growth? (One a scale of 1 – 10 (1 being the least)) 12345678910 Are you employed? YesNo Are you running your own hospital / Clinic? YesNo When did you set up your own hospital / clinic? What is the specialty of your hospital? What is your business goal for attending this Master Class? What is your personal goal for attending this Master Class? Any other inputs: