First Name *:

Surname:

Sex:

Age:

Country of Origin:

English language spoken:

English Language Reading:

Describe your past experience and knowledge of Buddhism, if any :

Describe you past experience and understanding of meditation, if any:

Describe as best you can your current religious or spiritual perspectives:

I intend to stay for :

nights (3 night minimum) or ordained stay for

Start Date Monday:

Special Dietary Requirements:

Accommodation arrangements:

Male applicants only:

**Office Use Only** (Agents Code):

Email *:

Although the program is reasonably priced we do only supply the price on application. Please be aware that filling out the application form in no way commits you to doing the program. Once you have completed an application or enquiry form we will provide you with all relevant information, from there you can begin to decide which program best suits your circumstances. Programs begin every Monday.