BZC Sesshin Application
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Email *
First Name *
Last Name *
Age *
Street Address *
City *
State *
Zip Code *
Emergency Contact Name *
Emergency Contact Phone Number *
  Are you a member of Bay Zen Center? *
Have you recently stopped taking any medications? (non-members) *
Sesshin Dates (Select One)                                                 *
If circumstances make it impossible for you to pay in the range stated, please pay what you can. No one is turned away for lack of funds.
Form of Payment *
Please pay as much of the sliding scale as you can afford, as this will support others who cannot afford to attend as well as the center and the teacher. Our intention is to make our offerings available to everyone. We keep our fees as low as possible. Please don’t let financial issues prevent you from attending. No one is turned away for lack of funds
Amount Paid *
Please let us know how much you paid so we can correlate this with payments received.
Do you have any dietary restrictions? (Does not apply when sesshin is on-line.) *
How will you attend? *
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