2021 祖師禪 禪七 Chan 7-day Retreat ◆Application Form
Welcome to the Intensive -day Retreat at Chan Grove! Please fill in the registration form below and email to
inquiry.ccc@gmail.com
. We will reply within 10 working days about our admission decision. Please fill in the form completely. Thank you.
Venue：198, Fuxing 3rd Road, Beitou District, Taipei City, Taiwan
7-Day Retreat for New Year : Feb 13 (Sat.) 17:00 Register~Feb 19 (Fri.) 16:30 Retreat concluded
* item must be filled in
歡迎您報名參加2021.2.13(週六)~2021.02.19（週五）或是 2021.7.17(週六)~2021.7.23（週五）的祖師禪 禪七活動！請您完整詳實填寫報名資料。我們將在收到您的報名表後10個工作天內，寄發錄取通知。
為提高報名流程的作業效率，資料不齊全者恕不受理。請您珍惜報名和錄取的機會。任何疑問請電洽 (02) 2891- 5205 (※活動地點：台灣台北市北投區復興三路198號/祖師禪林 )
* Required
Email address
*
Your email
我想報名參加：
*
2021.2.13(週六)~2021.02.19（週五）的祖師禪 禪七
2021.7.17(週六)~2021.7.23（週五）的祖師禪 禪七
Other:
Required
Personal information/個人資料名
Name/姓名
*
Your answer
Date of Birth/生日
*
EX: 1972.03.21
Your answer
Gender/性別
*
Male /男
Female/女
Required
E-mail Address/電子信箱
*
Your answer
Nationality/國籍
*
Your answer
Marital Status/婚姻狀態
*
Single/未婚
Married/已婚
Others/其他
Required
Correspondence Address/通訊地址
*
Your answer
Contact Number(Day) /連絡電話(日)
*
Your answer
Mobile/行動電話
*
Your answer
Emergency Contact/緊急聯絡人
*
Name/Relationship/Contect Number (姓名/關係/連絡電話或行動電話)
Your answer
Highest Education(學歷)
School/Department /Degree(學校/科系/學位)
Your answer
Company(服務單位)
Current(現職)
Before Retirement(退休)
Position(職位)
Your answer
Religion(宗教信仰)
*
Buddhism(佛教)
Catholic(天主教)
Christian(基督教
Islam(伊斯蘭教)
Others(其他)
If you are a Buddhist, who is your Master?(皈依師)
Your answer
Meditation books and authors you read(主要閱讀的禪修著作及作者)
Your answer
What do you wish to get out of this retreat?(參加動機，因緣及目的?希望得到甚麼樣的協助及指導?)
*
Your answer
Remarks (Special medical attentions or other matters...)備註(特殊體質或其他事項)
Your answer
Previous Chán Retreat Experience/禪修經歷
Do you have any Chan Retreat Experience?/是否曾有禪修經驗?
*
Yes (Please complete the below section)/ 是(請續填寫下列問題)
No/否
Shortly Describe Your Chan Retreat Experience/請簡述您的禪修經歷
Your answer
Recent Chan Retreat Experience(Make one example)/最近曾參加的禪修活動(請舉1例)
Name of the Retreat/ Organizers /Date(禪修活動名稱/主辦單位/時間)
Your answer
Have you ever participated in any activities organized by Chan Grove?/是否曾參加祖師禪林或玉佛寺的禪修活動?
*
Yes/是
No/否
Meditation Experience in the past six months/最近半年禪坐情形?
*
Regular Home Meditation or Regular Group Meditation, _____times per week, _____mins each time/固定在家打坐或參加禪坐共修，每周_____次，每次________分鐘
Your answer
Meditation Methods/禪修方法
Reciting the Buddha's name/念佛
Counting the Breath/數息
Awareness of the Breath/隨息
Vipassana/止觀
Silent Illumination/默照
Hautou/話頭
Others/其它
Health Condition/健康情形
Do you have any of the problems listed below?/是否有右列各項疾病或健康問題？
*
Back Problem/背部疾病
Leg Problem/腿部疾病
High Blood Pressure/高血壓
Low Blood Pressure/低血壓
Allergy/過敏
Asthma/哮喘
Infectious Diseases/傳染性疾病
None of the above/以上皆無
Required
Serious emotional or psychological disorders?/嚴重的情緒障礙或心理不適應症?
*
No/否
Yes/是
If "Yes", Please describe it/如填"是"，請略述情況
Your answer
Have you had major surgery?/您是否曾動過重大手術？
*
No/否
Yes/是
If "Yes", Please describe it/如填"是"，請略述情況
Your answer
Other health problems?/其它須特別遵守醫囑的健康問題？
No/否
Yes/是
Clear selection
If "Yes", Please describe it/如填"是"，請略述情況
Your answer
Do you agree and are willing to abide in the following: (please check/請打勾表示您同意或願意遵守該則注意事項 Throughout the whole Chán Retreat, I agree
*
To comply with the provisions of the daily routine (get up at 04:30, bedtime at 22:00)我同意遵守禪坊作息規定（每天4:30am起床，10:00pm就寢）
Besides teacher's interaction and sharing, remain silent at all times/除了課程安排所需的心得發表之外，我同意全程禁語
Not to use the phone (Please understand the need to allow us to keep your cell phone during the retreat) /我同意全程不收聽、不撥打電話（報到時需交出手機，由義工代為保管）
Not to read newspapers, magazines or books/我同意全程不閱讀報章雜誌或書籍
Not to use a computer or other electronic devices/我同意全程不使用電腦或其它電子用品
To comply with the instructions of the workshop instructors, meditation instructors, volunteers/我同意全程遵守工作坊指導者、禪修指導者、義工的指示
Not to drink, not to smoke, not to take drugs, not to take non vegetarian food/我同意全程不喝酒、不抽菸、不吸毒、不葷食
To accept the living conditions and training throughout the retreat/我願意全程接受最基本的生活條件和各項訓練
To accept the intensive teachings in the retreat including pressuring and hitting/我同意接受禪期中逼拶棒喝的嚴格教法
Required
Please click the box below to submit :
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
