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Application for Vallecitos 2024 LGBTQIA2S+ RetreatÂ
If you wish to attend this retreat, the first step is to submit this application for review.
Your privacy is a priority. All responses will be kept confidential.
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Email
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Your email
Please re-enter your email address
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Your answer
First Name:
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Your answer
Last Name:
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Your answer
What gender pronouns should we use when referring to you?
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Your answer
Phone:
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Your answer
City/Town
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Your answer
State/Location
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Your answer
Postal Code
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Your answer
Age:
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Your answer
How do you self-identify your racial and ethnic heritage or background?
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Your answer
How do you self-identify your sexual orientation?
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Your answer
How do you self-identify your gender identity?
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Your answer
Please share any other identities that are important to you:
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Are you new to meditation practice?
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Yes
No
If you answered NO above: How long have you been practicing meditation and with what traditions, teachers or centers?
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Is this your first residential retreat?
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Yes
No
If you answered NO above: Is this your first retreat at Vallecitos?
Yes
No
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If this is NOT your first residential retreat: Please list residential retreats you have attended (where, when, how long, and with whom).
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What motivates you to do a retreat at this time?
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Will you need a scholarship for this retreat. [This question is for planning purposes only and will NOT affect your application.]
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Send me a copy of my responses.
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