Meditation Teacher Training, Fall 2019
Nalanda Institute for Contemplative Science
https://nalandainstitute.org/

Meditation Teacher Training in Mindfulness and Loving-kindness
https://nalandainstitute.org/meditation-teacher-training-fall-2019/

Contact: Anu Kulkarni Wells, anu@nalandainstitute.org

CONTACT INFORMATION
First Name *
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Last Name *
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Phone, work/office *
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Phone, cell *
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Email *
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MEDITATION EXPERIENCE
What style... *
What style and what tradition is your meditation practice?
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Frequency... *
How frequently do you practice and for what length of time?
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When... *
What year did you begin your practice?
Your answer
Teachers *
Have you worked closely with any particular teachers, and if so, whom?
Your answer
Retreats *
Have you participated in any meditation retreats (please give approximate dates and durations)
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PROFESSIONAL QUALIFICATIONS
Degrees *
List all degrees. For each, please include: 1) degree, 2) date obtained, 3) university and/or institute.
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Current employment *
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Past employment *
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Areas of specialization / advanced training: *
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ADDITIONAL INFORMATION
Personal statement *
Please describe what brings you to this work, and what do you hope to gain from this level of engagement?
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Concerns
Are there any concerns related to your physical and/or psychological health that may impact your capacity to participate and function in the meditation, didactics or retreat during the training? If so, please describe.
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How did you hear about this program? *
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SIGNATURE
Typing your name below qualifies as a signature and is a confirmation that the information above is valid, accurate, and complete.
Name *
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Date *
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