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Vedic Cartography Course Form

Please fill out this brief questionnaire to help us better understand what you are hoping to gain from this course - if you did your Keys for Transformation Reflections this should be easy.

Click the button below to start.

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Question 1 of 15

Full Address

Question 2 of 15

Phone Number

Question 3 of 15

Date of Birth

Question 4 of 15

Age

Question 5 of 15

Occupation

Question 6 of 15

Approximate Initiation Date

Question 7 of 15

Who were you initiated by?

Question 8 of 15

When was the last time you meditated, and for approximately how long did you meditate for?

Question 9 of 15

Are you currently experiencing any difficulties in your meditation practice? If so, please explain as concisely as possible.

Question 10 of 15

What is your intention for signing up for the Vedic Cartography Course and what do you hope to get out of it?

Question 11 of 15

What are some of the ways you would like to receive support throughout the duration of this program? Check all that apply:

(Select all that apply)
A

Course Forum

B

Occasional check-in emails

C

Follow-up support calls (group)

D

YouTube Links

E

Podcasts

F

Inquiry questions

Question 12 of 15

Any other feedback or comments you want to share that you feel is relevant?

Disclaimer

Meditation and it's accompanying philosophy, including Ayurvedic practices and principles, as well as any additional supportive course materials, although beneficial, is not a substitute for medical care, advice, or medications. If you wish to stop taking any medications or are unsure if meditation is appropriate for you, please consult your primary care physician.

If you are struggling with any mental health conditions, although meditation can help, it is not meant to replace the help, direction and care of a qualified physician. Please seek out professional help if needed. If you do not have a practitioner whom you can see, let ask now and we can help you find someone.

In the unlikely event that you experience an injury or negative side effects from any of these meditation practice, Instill Meditation including Caryn Kilback and all guest or contracted teachers will not be held liable. The completion and submission of this form serves as your official release.

Question 14 of 15

If you understand and agree with the above disclaimer, click the box below

(Select all that apply)
A

I agree

Question 15 of 15

Course Agreement
Vedic Meditation is taught as a sequence. You are agreeing to the next leg of the Vedic Meditation course sequence to receive Advanced teachings and techniques, which may be an elaboration of your current practice, or eyes-open practices. Included in this course is your Ceremony Initiation, the Cosmic Body Technique, group rounding sessions, instructional knowledge meetings, and recording access to all lectures.

(Select all that apply)
A

I agree

Confirm and Submit