Examination Centre Consent Form

To

Exam Controller MSPL , PrCB
Approved by Yoga Certification Board
(Ministry of Ayush,Govt of India )


We are submitting our consent to provide you the required infrastructure for the examination to be conducted by you with following details.

(A) Institution Details

(B) Personal Information

S.No.	Designation	Name	Email ID	Mobile Number
1.*
2.
3.
4.
5.

(C) Infrastructure Details (Select One from each)

S.No.	Room Type	Furniture	Air Conditioned	Seating Capacity
1.	Select Hall Room	Select Table Chair Bench Other	Select Yes No
2.	Select Hall Room	Select Table Chair Bench Other	Select Yes No
3.	Select Hall Room	Select Table Chair Bench Other	Select Yes No

(D) Examination Details

Subject :	Voluntary Certification of Yoga Professional
Type of Exam (Theory / Practical) :	Theory & Practical
Date of Exam :		Time : 9:00 AM to 7:00 PM
Expected Number of Students :

I hereby certify that the information provided above is true to the best of my knowledge and belief. If any information is found to be false/ incorrect, it will reject my centre in MSPL-PERSONNEL CERTIFICATION BODY , HISAR.

Yours Truly

Name :
Designation :
Date :