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Vallecitos 2020 POC Retreat Application
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First Name: *
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Last Name: *
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Age: *
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Race: Check all that apply *
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Ethnicity:
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Sexual Orientation *
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Gender Identity: (Check all that apply) *
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Other identities you would like to share with us:
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Are you new to meditation practice? *
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? *
If you answered NO above: Is this your first retreat at Vallecitos?
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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Why do you want to attend this retreat? *
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Will you need a scholarship for this retreat. If so, do you need a partial or full scholarship? [This question is for planning purposes only and will NOT affect your application.] *
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