Application form Dhammakaya Meditation  Retreat (DMR)
When you have finished the form, please click "submit".
Google にログインすると作業内容を保存できます。詳細
Name *
Surname *
Sex *
Which program would you like to apply for? *
Address *
Postal code *
City *
Country *
Telephone number *
Email address
Date of birth *
YYYY
/
MM
/
DD
Did you ever meditate before? *
If so, which method do you normally use?
選択を解除
How long have you been meditating, using this method?
How did you learn about our meditation retreat? *
From friends, from a website, etc. Please specify the website.
Have you ever received treatment by a psychologist or psychiatrist? *
If so, briefly describe the reason for you getting treatment, and the nature of your complaints
If you have answered the above question positively, it may be helpful to contact our organization before applying for a program, because psychological conditions can affect your meditation practice and vice versa. We might also contact you to discuss this with you.
Do you have any serious medical condition that could affect meditation practice? *
Do you have any dietary requirements or other things to be taken into account with regard to a medical condition? Do you have any allergies? *
I am applying to the above mentioned program and herewith declare that I will adhere to the rules and regulations of the retreat, as far as I am able to. I am aware that if there are certain parts of the program that I cannot or will not attend, for any reason whatsoever, I am not obliged to do so in any way.  I will not hold the staff of the retreat responsible for any negative effects as a result of the retreat program. *
Signature
We will send you a confirmation email with more info.
Please make sure that the email address we use, info@dhammakaya.nl, is whitelisted and doesn't go to your spam box.
送信
フォームをクリア
Google フォームでパスワードを送信しないでください。
このコンテンツは Google が作成または承認したものではありません。 不正行為の報告 - 利用規約 - プライバシー ポリシー
Google フォーム