APPLICATION FOR
PERSONAL MEDITATION RETREAT

Please read all the information on the retreat description page closely before completing the form below.

Please answer all the required questions so that we will have all the information we need to process your application.

Your name

First Name

Last Name

Please type it carefully to be sure it's correct or we won't be able to reach you. IMPORTANT: When asked for your email address, do not give one that uses the Boxbe filtering service, as it is incompatible with our application system and thus you may not receive emails from us. We recommend you use an email address that does not use Boxbe.

Nationality

Age

Gender

Preferred pronouns

E.g. she/her, they/them, he/him, or whatever you prefer.

Address

Your residential and legal address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Your mobile phone number

Start with country code, e.g. +91 (if India)

Passport info (for those who are NOT citizens if India)

If you are NOT a citizen of India, please enter your passport number, country, date of expiry, and place of issue.

Emergency contact

Provide the best person to contact in case of emergency. Please enter the name, phone number, email address, and relationship (e.g. mother, husband, friend). If you'd rather give us this info when you arrive, thats OK too, but we will need to have it before you begin your retreat.

About your retreat & your practice

The following questions help us understand exactly what kind of retreat experience you're looking for, so that we can know your wishes and consider how best to support you. We respect your privacy and your answers will be kept confidential.

Which type of retreat best describes what you wish to do?

Please elaborate in detail on the kind of retreat you'd like to do.

Desired start date for retreat

Please enter the date you would like to start your personal retreat if possible. If your dates are flexible, please provide your best estimate of the time period within which you might wish to begin.

Desired duration of retreat

How many days/weeks/months would you like to do formal retreat?

Practice guidance

Have you studied and practiced meditation with a teacher? If so, please give details so we can understand your practice background.

Practice experience

Tell us about your prior experience with meditation practice. For example, do you meditate daily, or almost daily? And for how long have you been doing regular meditation practice?

Past retreat experience

Have you done any other meditation retreats in the past? If so, what and where?

Why are you interested to do your retreat at Dharmalaya Institute?

Please give a thoughtful response here so we can understand what you're wishing for. What attracts you to do retreat in this place? What kind of experience are you hoping to have?

Is there any particular support you might need during your retreat?

This could include no-contact food delivery in case of strictly solitary retreats, or practical matters like shopping for ritual provisions, as well as practice guidance, emotional support, or other kinds of support for your practice. Please give is some thought and let us know what needs you might have.

Mental and emotional state

Please let us know if you have had any prolonged struggles with mental or emotional well-being. (Your response is for our retreat facilitators only, and will be kept private and confidential.)

Do you have any injuries, medical conditions, or other health concerns?

For example: Are you taking any medications? (If so, what medications, and for what conditions?) Do you have any allergies or sensitivities? Any physical limitations such as difficulty sitting or walking, back pain etc.? If yes to any of the above, please give details.

Dietary preferences and/or allergies

We serve only healthy, mostly-organic, plant-based (vegan vegetarian) cuisine. We also do our best to accommodate special needs, so if you are diabetic or have food allergies, gluten intolerance, etc., please leet us know so we can take care of you.

How did you come to know about Dharmalaya Institute? (Check all that apply)

A friend who has participated in Dharmalaya programme(s)

A friend who had heard or read about Dharmalaya

Search engine (Google, etc.)

Facebook

Instagram

Other

Name(s) of person(s) who told you about Dharmalaya Institute

If a friend/colleague/classmate/etc. told you about Dharmalaya Institute, what is that person's name?

Travel experience

Additional comments

Anything else you'd like to tell us?

Just one more step:

After you click the 'submit' button below, your application will be sent to us for review. Follow-up questions and/or an online interview are often part of the application process. After we have reviewed your application (normally within 1-2 weeks), we will send you an email that will notify you of your application status (e.g. pending interview, pending receipt of deposit payment, waiting list, etc.).

APPLICATION FORPERSONAL MEDITATION RETREAT

Please read all the information on the retreat description page closely before completing the form below.

Please answer all the required questions so that we will have all the information we need to process your application.

APPLICATION FOR
PERSONAL MEDITATION RETREAT