Registration Form

Please fill in the details below as mentioned in order to proceed towards the course. All details submitted will be kept confidential and only used for internal purposes. 

Personal Details

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Contact Details

Permanent address


Professional Details


Course Details

Have you attended a course by Anil before?
Which mode would you prefer attending the course?


Please read all the guidelines mentioned below. We are extremely serious about our policies and expect you to be the same about them:

- The course will begin at 2:30pm sharp, irrespective of the number of participants present. This holds true for all days
- Please clear all payments in order to receive certification.
- Successful completion of the Integration process is also required for the certification
- Courier of your certification kit within India is free of cost and is included in your course fee. For couriers outside India, the participant (you) will have to bear the charges for the same.

- Photos clicked during the sessions will be used for future references.


For online participants:
- Please ensure that you join in for the Live-Online class with a laptop or a monitor along with wireless earphones/headphones, good lighting and video ON at all times. 

For offline participants:

- Please carry headphones (preferably wireless) so that you can co-ordinate with your partner seamlessly during the activities.
- If you have any food preference (Jain or other), please inform our team during the time of filling this form as we can then make necessary arrangements.


- Anil Thomas NLP and Gestalt shall fully indemnify, hold harmless and defend all its employees, practitioners and affiliates from and against all cost and expenses, actions, suits, losses, settlements, involving a claim from the opposite party regarding a mishap happening during the treatment, if any. 
- The company is not liable to pay or indemnify the third party, the therapy sessions are purely based out of the personal will of the individual and is not forced upon him/her in any kind. 
- Therefore, we want to inform and stress upon the statement that being a part of these sessions is completely your own choice and the risk encountered if any, will be borne by you.