TISARANA VIHARA MEDITATION
CENTRE
357 NELSON ROAD, WHITTON, TWICKENHAM
MIDDLESEX, TW2 7AG, U.K. TEL/FAX: 020 8898 6965
APPLICATION FORM FOR MEDITATION RETREAT (http://www.nibbana.com/mediapli.htm) |
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1. Name: |
First and Middle: |
Last: |
2. Address: |
Post Code: Telephone: Home/ Mobile: |
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3.
Contact |
Name: |
Telephone No: |
4. Which course do you want to apply for? |
(a) First Choice
( Please Tick) |
(b)
Second Choice ( Please Tick) |
5. Please give exact dates if relevant: |
Start Date: Finish Date: Total: days. |
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6. Any previous experience of Meditation? |
Yes [ ] No
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7. Do you have any serious health problem or medical condition that might affect your meditation? |
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8. Do you need any special arrangement during your stay, e.g., vegetarian diet, medication, etc.,? |
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9. Name of any Religious organisations you are associated with: |
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The rules of Meditation Centre include observation of the Eight Precepts, such as abstaining from food after mid-day, alcohol, drugs and smoking. Strict observation of Noble Silence is practised during the retreat. I, ....................................................., agree to abide by the rules of Tisarana Vihara Meditation Centre, practise diligently and follow closely the instructions of the Meditation Teacher. |
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Signature: |
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Date: |