วดป.............................................................สถานที่ ................................................................................................

ขอมูลเบื้องตนหลักสูตรโยคะพื้นฐาน สถาบันโยคะวชิาการ

ประวัติบุคคล ช่ือ .............................................. นามสกุล .................................................... ช่ือเลน ..................... อายุ.............. ป ที่อยู ............................................................................................................................................................................. ............................................................................................................................................................................. โทรศัพท .................................................. มือถือ ............................................โทรสาร ........................................... e-mail ………………………………………………………………………………………………………………. อาชีพ ......................................................................................................................................................................... ระดับการศึกษา ......................................................................................................................................................... ประวัติการฝกโยคะ

• ทานเคยฝกโยคะมานานเทาใด ? ....................................................................................................................

• ทานเคยเรยีนโยคะทางใด? Δ ฝกจากหนังสือ Δ ฝกโดยครู ช่ือ .............................................. Δ อ่ืน ๆ ...................................

• ปจจุบันทานฝกโยคะสม่ําเสมอแคไหน? อาทิตยละครั้ง หรือ นอยกวา อาทิตยละ 2 คร้ัง

อาทิตยละ 3 คร้ัง มากกวาอาทติยละ 3 คร้ัง ปญหาสุขภาพ (ถามี) ....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... สิ่งที่อยากจะเรียนในคอรสนี้

• ภาคทฤษฎี .................................................................................................................................................................................................................................................................................................................................................................. ................................................................................................................................................................................

• ภาคปฏิบัติ ................................................................................................................................................................................. .................................................................................................................................................................................................................................................................................................................................................................

สิ่งที่คาดหวงัจากหลักสูตรนี ้................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................