Shiv Yog Club Formation Form

President
Name (in Capitals):
Dr. Chandra shaker
13/07/1955
(DOB: dd/ mm/ yyyy)
M
(Gender: M/ F)
SY40021
SYID
Vice President
Name (in Capitals):
R.S
(DOB: dd/ mm/ yyyy)
(Gender: M/ F)
SY16890
SYID

8/12/1952
M

Secretary
Name (in Capitals):
ANURAG
(DOB: dd/ mm/ yyyy)
(Gender: M/ F)
SY22087
SYID
Number of Members to form Shiv Yog Club
The minimum number of members required to form a club is 30
Specify the number of members of your club

5/12/1970
M

Nos 38

Shiv Yog Club Venue Details

Address
2/2 , Lane no 2 , Shastri Nagar , Dehradun -248001
Time
Tick whether the Venue is at :
Home
Temple
External Venue
Any other Venue

Minimum Size of the room

Please specify the details below:
If the room is being used for any other activity
What arrangement for Lighting do you have?
No of Windows
No of Doors
No of Fans
What is the colour of room?
What kind of Carpet is there?
How many Yantras are in your room?
(Specify if there is any other painting in the room
Audio / Visual Arrangements
Details of LCD
Size of LCD ( minimum is 42")
Model of the LCD
Sound System
No of Speakers
Model of the Speakers
DVD Player
Model of the player
For Power Back up you have:
Generator ( name of Company)
(it should not create any disturbance)
Inverter ( name of company)
(It should be enough if the power goes off)
Do you have Laptop?
Is there any internet conectivity ?
Name of the internet service provider
What is the Data plan
What is the speed?
Activities in your Club
Shiv Yog Events

300 sq. ft.

Details
Only For Shiv Yog
3 Tubelights, 4 CFL
2 Windows
2 Doors
2 Fans,
Light Cream & Off white
Tiles Flooring
1 Sri Yantra & 1 Mahamrityunjaya & 1 Sumangal Yantra
No

Details
LCD 42" & Projector with Screen
LG
2
150 Watt Woofers Intex
Universal DVD Player

No
Luminous
8-9 hours backup
Dell Laptop

MTS
40 GB
3G speed (7.2 mbps)

Satsang Dhyan
Weekly Dhyan
Shivanand Day
any other
Service to Nature and Mankind
Durga Saptashati Shivir
Kissan Shivir
Saraswati Deeksha
Cultural Activities ( Proposed)

Kindly suggest the activities you want to organize

Please provide at least three references of Shiv Yog Sadhaks

Reference 1:
Name
Contact no
Address

Shashi Bala
8126226936

Reference 2:
Name
Contact no
Address

Shalu Rani
8958050968
Listrabad, Ranipokhari, dehradun, Pin-248145

Reference 3:
Name
Contact no
Address

Sanjay Kaushik
9897621995
36-Maharani Bagh, Dehradun Pin-248001

Chosen Members of Shiv Yog Club:

Provide the contact details of all the thirty chosen members of the Club. The SYID profile of all memebers should be
complete with their photo ID and address proof uploaded.
S no Name
SYID
Contact no
Email ID
1 Kavita Sisodia
SY22083
9410542643
kavitasisodia@gmail.com
2 Punam Belwal
SY20355
9997023433
belwal14@gmail.com

3 Sushila Dabral
4 pushpendra singh jarodia
5 Seema Gupta
6 Shubhi Belwal
7 Chandra Shekhar Dimri
8 Sushma Dingri
9 R.S. Rana
10 Hira singh rawat
11 Kusum Deorani
12 Satya Rawat
13 Sumitra Rana
14 Pyare Lal Dabral
15 Hemlata Dabral
16 Akanksha Bahukhandi
17 Sushmita Bahukhandi
18 Anurag Sisodia
19 Gajendra Dutt Belwal
20 Suresh Gupta
21 Parul Gupta
22 Shashwat Uniyal
23 Shobha Uniyal
24 Ravindra Kumar Goswami
25 Ram Kishore Jadli
26 Kavita Jadli
27 Jyoti Negi
28 Shefali
29 Praveen Kumar garg
30 B. P. Painuly
31 Bina Painuly
32 Vivek Painuly
33 Shashwat Uniyal
34 Shobha Uniyal
35 Rajni Uniyal
36 Anuradha Karnwal
37 Savita Pal
38 Vinod Bhasin

SY40426
SY16386
SY10060
SY34190
SY40021
SY9744
SY16890
SY9692
SY38425
SY36344
SY16890
SY40425
SY38428
SY39711
SY39712
SY22087
SY39120
SY10069
SY10006
SY28630
SY28634
SY11826
SY23323
SY23274
SY23325
SY20871
SY12667
SY2006
SY33271
SY797
SY28630
SY28634
SY798
SY24734
Sy14895
SY13199

9639215396
8909450158
9837079989
8126709801
shubhi.belwal@gmail.com
8127667313
cs.dimri@newindia.co.in
9897637424
9412402879
rsranashivyogi@gmail.com
9719037677
rawat.hs3676@gmail.com
9411486056
9997552436
satya004@gmail.com
9557007427
9639215396
9410192342
8126567550
9456166865
9997151830
indofursystem@yahoo.co.in
9837625051
gdbelwal@gmail.com
9837017426
sureshshivyogi01@gmail.com
9808780001
popitopi16@gmail.com
9997582004
shashwatuniyal01@gmail.com
8191901088
7417366182
rkgoswamy18@gmail.com
9410147859
rkjadli@rediffmail.com
9410147859
9410147859
9411173274
8909718233
9410575997
praveengarg61@gmail.com
9412076628
9411174704
9897909120
9997582004 shashwatuniyal01@gmail.com
8191901088
9897909120
9760912638 anuradha6887@gmail.com
9557113250 palsavita27@gmail.com
9412955550 vinodbhasinbsnl@gmail.com

Request: Dear sir After talking/ Disscussion with all club members . We have decided to change our president by the name of Dr.
So please accept this form/list as a final form/list.
Thanks
Namaha Shivaya

Dimiri

RANA

SISODIA

os 38

ehradun -248001

hite

1 Sumangal Yantra

Screen

tex

er

s)

un, Pin-248145

Pin-248001

memebers should be

Email ID
avitasisodia@gmail.com
belwal14@gmail.com

hubhi.belwal@gmail.com
s.dimri@newindia.co.in

ranashivyogi@gmail.com
wat.hs3676@gmail.com
satya004@gmail.com

dofursystem@yahoo.co.in
gdbelwal@gmail.com
eshshivyogi01@gmail.com
popitopi16@gmail.com
shwatuniyal01@gmail.com

goswamy18@gmail.com
rkjadli@rediffmail.com

9411173274

aveengarg61@gmail.com

watuniyal01@gmail.com

ha6887@gmail.com
ita27@gmail.com
hasinbsnl@gmail.com

e our president by the name of Dr.

Dr. Chandra shaker

dimri