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Holistic Progress that preserves your values
Holistic Progress that preserves your values
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ABOUT
About Yujom®
Founder – AntahKaran Scientist Lalit
Kalpdroom® Science System
Kalpdroom® Quantum Science Input → AntahKaran® → Conscious Action
Vision, Philosophy & Science
Our Services Objectives
Photo Gallery
Contact
Participation
DreamSleep® – Prescribed Participation Pathway
DreamSleep® – Choice & Capacity Participation Pathway
Student Ambassador Program
DreamSleep® Manifesto
DreamSleep® Structured Session Schedule
DreamSleep Renewals
Programs
Webinars
Seminars
Workshops
Retreats
Closed Group Pathway (One-Year Group Program)
Leadership & Outreach Programs
Coordinators Program (Non-Students)
Academic Partners Program
Healthcare Partners (Medical & Paramedical)
Home-Based Authorized Center Partner Program
COLLABORATION
Educational Institution Collaboration Pathway
Innovation & Research Pathway
Impact
Testimonials (Written)
Testimonials (Video & Audio)
Success Stories
Home-Based Authorized Center Partner Application
A) Applicant Identity
Full Name
(Required)
Date of Birth
(Required)
DD dash MM dash YYYY
Gender
(Required)
Male
Female
Other
B) Home-Based Center Location
Full Address (Home/Center Location)
(Required)
C) Language & Communication
Languages you can conduct sessions in
(Required)
Hindi
English
Gujarati
Marathi
Bengali
Tamil
Telugu
Kannada
Malayalam
Punjabi
Other
If your language is other, specify here
Primary language for our communication
(Required)
Hindi
English
Gujarati
D) Background
Current role
(Required)
Student
Working Professional
Self-Employed
Homemaker
Teacher/Trainer
Healthcare/Paramedical
Other
If your current role is other, specify here
Highest education
(Required)
10th
12th
Diploma
Graduate
Post-Graduate
Doctorate
Other
Any prior experience in coaching/counseling/yoga/meditation/wellbeing?
(Required)
Yes
No
Brief experience summary (max 6–8 lines)
(Required)
E) Readiness & Commitment
Why do you want to become a Home-Based Authorized Partner?
(Required)
Time availability per week
(Required)
2–4 hrs
5–7 hrs
8–12 hrs
12+ hrs
Preferred delivery mode
(Required)
DreamSleep Group Sessions
1:1 Counseling-Coaching
1:1 Consulting
Mixed
Preferred session timings
(Required)
Morning
Afternoon
Evening
Night
Home space readiness
(Required)
Ready now
Ready in 2–4 weeks
Need guidance
Approx room environment
(Required)
Quiet & private
Shared home space
Separate room available
Can host small group (5–15)
F) Compliance & Ethics
Centralized payment acceptance
(Required)
I agree that all participant contributions will be collected only through Yujom® centralized registration/payment.
Non-medical boundary acceptance
(Required)
I understand this is complementary wellbeing support, not medical/psychiatric treatment. I will not claim cures or guaranteed outcomes.
Confidentiality & conduct acceptance
(Required)
I agree to confidentiality, ethical conduct, and participant safety norms.
Other job/business disclosure
(Required)
Yes
No
Briefly mention your other job/business
(Required)
G) Document Uploads (Verification)
Photo ID Upload
(Required)
Drop files here or
Select files
Accepted file types: jpg, gif, png, pdf, Max. file size: 2 GB.
Note: Aadhaar/Passport/Driving License/Voter ID
Recent Photo Upload
(Required)
Drop files here or
Select files
Accepted file types: jpg, gif, png, pdf, Max. file size: 2 GB.
Session Space Photos
(Required)
Drop files here or
Select files
Accepted file types: jpg, gif, png, pdf, Max. file size: 2 GB.
(2–4 photos)
H) Contact
WhatsApp Number (Phone)
(Required)
Email Address
(Required)
Enter Email
Confirm Email
I) Fold-1 Foundation
Are you already a Fold-1 participant?
(Required)
Yes
No
Your Unique Kalpdroom Code
(Required)
Fold-1 Registration Name (as used in registration)
(Required)
Fold-1 Registered Mobile/Email (match your record)
(Required)
Fold-1 Start Preference
(Required)
Start immediately
Within 7 days
Within 30 days
J) Ethics & Consent
Culture Lock Agreement
(Required)
I follow No Pressure
I follow No Promises (no guarantees/clinical claims)
I follow Respect & Consent (privacy/dignity)
Data Consent
(Required)
I consent to be contacted by Yujom® team for verification and onboarding.
K) Reference (Optional but Recommended)
Reference Full Name
Reference Phone Number
Reference Relationship
Friend
Senior
Teacher
Professor
Coordinator
Other
I confirm that I have informed the reference person before sharing their contact details.
(Required)
I confirm that I have informed the reference person before sharing their contact details.
L) Final
Declaration
(Required)
I confirm the information provided is true to the best of my knowledge.
Final
(Required)
Website
WhatsApp
Friend
College
Social Media
YouTube
Other
M) Submit
Signature / Full Name as Agreement
ABOUT
About Yujom®
Founder – AntahKaran Scientist Lalit
Kalpdroom® Science System
Kalpdroom® Quantum Science Input → AntahKaran® → Conscious Action
Vision, Philosophy & Science
Our Services Objectives
Photo Gallery
Contact
Participation
DreamSleep® – Prescribed Participation Pathway
DreamSleep® – Choice & Capacity Participation Pathway
Student Ambassador Program
DreamSleep® Manifesto
DreamSleep® Structured Session Schedule
DreamSleep Renewals
Programs
Webinars
Seminars
Workshops
Retreats
Closed Group Pathway (One-Year Group Program)
Leadership & Outreach Programs
Coordinators Program (Non-Students)
Academic Partners Program
Healthcare Partners (Medical & Paramedical)
Home-Based Authorized Center Partner Program
COLLABORATION
Educational Institution Collaboration Pathway
Innovation & Research Pathway
Impact
Testimonials (Written)
Testimonials (Video & Audio)
Success Stories
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