2022 Long Application Form [Feb-Dec]
Dear Friends,
     Once we have reviewed the form, we will get back to you with  recommendations. When you hit the submit button at the bottom of this page you will see a confirmation message come up on your screen. That means we have received your form. Please wait for us to send you recommendations; we will do our best to respond in a timely manner.
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Email address *
Snail Mail Address [street, city, state/province, country, zip/postal code] *
Telephone number/cell number *
Sex *
Birth date (Month/Day/Year) *
Marital Status *
Number and ages of children *
Driver's License or Passport Number *
What retreat/event are you applying for? *
What are the arrival and departure dates that you are requesting? Are you driving or flying? *
Person to Contact in Case of Emergency: List their full name, phone, email, address and their relationship to you *
Since you are applying to stay at the Abbey, which is the home of monastics, we will ask your some personal questions to get to know you better. This information is also useful in helping you progress along the path more effectively. All information will be kept confidential and will be shared only in case of emergency. *
How long have to been actively studying and practicing Buddhadharma? *
Please tell us about your Buddhist studies. *
Do you have a teacher? If so, whom? How long have you studied and practiced under this person's guidance? *
Do you do a daily meditation practice? If so, what meditation(s) do you do? Add any other information about your religious/spiritual background that could be helpful. *
Have you done any meditation retreats or long courses? Please describe *
Have you received the five lay precepts? Monastics precepts? Bodhisattva precepts? Who did you receive the lay and/or monastic precepts from? *
Why would you like to attend this program? Or, if you are applying to stay for a period of time at the Abbey, why would you like to do so? *
What is your educational background? What have you studied and at which schools? What degrees have you received? *
How do/did you earn your living? *
What skills do you have that you would like to offer to the community during the periods of offering service (for example, building, electrical, plumbing, gardening, maintenance, cooking, transcribing, editing, computer, IT, fund raising, graphic designing etc....? *
Please read the details of our daily schedule on our website at the following address  and view the schedule below          https://sravastiabbey.org/who-we-are/day-in-life/            Are you willing and able to participate fully in our daily schedule? *
Sravasti Abbey Schedule
The next several questions need to be answered with as much detail as possible. Complete responses enable us too understand and appreciate the conditions that could impact your safety, health, and ability to live here with others. Answering yes to any of these questions does not exclude you from joining us. *
Do you have a chronic illness or injury? If so, please describe. *
Do you have physical limitations that may interfere with or might be aggravated by sitting practice or by offering service while at the Abbey? If so, please describe. *
Do you prefer to sit in meditation and in teachings on a *
Please list all medications that you take (prescription and over the counter) and the medical conditions they are treating. *
Are you allergic to: any medications, drugs, insect bites or foods? *
What medicines do you use if you have an allergic reaction? *
Do you snore such that it could disturb a roommate? *
Health Insurance is a requirement to spend time at Sravasti Abbey. Please give details (insurer, id number). Please give the name and contact information of your physician. If you live outside of the United States you will need to purchase travel health insurance prior to your arrival in the USA *
Have you ever had or been treated for a psychological condition such as depression, eating disorder, drug/alcohol addiction, anxiety disorder, psychosis, schizophrenia, bipolar, or any other psychological conditions: Please specify the condition(s), date(s), and treatment (including medicine) you received. *
Have you ever spent time in a mental health institution or drug/alcohol rehabilitation center (inpatient or outpatient)? When? If so, please describe *
Please describe your experience with psychotherapy, if any. Are you currently seeing a therapist or counselor? *
Do you currently use alcohol, recreational drugs, or tobacco on a regular basis? If so, are you prepared to abstain from using them for the duration of your stay? *
Are there conditions in your life that might be placing you under stress or that could make living at the Abbey challenging? (e.g. divorce proceedings, debt, substance abuse, withdrawal, loss of a loved one, etc.) *
Have you ever been convicted of a crime? If so, please describe. *
Please describe your experience if any in the areas of the healing arts, channeling, rebirthing, occult practices, etc. *
Please list two references (not relatives) One should be a recent employment supervisor.   For each person list their: name, phone, email, address (street, city, state, zip, and country. What is your relationship to the person and how long has this person known you? *
Safety Net. Please list a person who will be your "safety net," a person who will provide for you, should you need to leave the Abbey for any reason. If it is one of your personal references, just list the name *
Please send an image of your Covid-19 Vaccination card including booster shots you have received to office.sravasti@gmail.com ( Without proof of vaccination against Covid-19, we cannot accept your request to visit.) *
Please have a PCR Covid 19 test taken within 72 hours of coming to the Abbey and send us the results before you arrive *
Have you read the guidelines  for staying at the Abbey https://sravastiabbey.org/visit/guidelines/ and do you agree to follow them? *
Please read the "Visiting" section of our website? https://sravastiabbey.org/visit/ *
Do you have any concerns about staying at the Abbey?    If so, please tell us. *
If you have specific accessibility questions, please email us at office.sravasti@gmail.com *
By entering your initials in the box below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge. *
Date (month, day, year) *
Everything on this application is true and complete to the best of my knowledge. I authorize Sravasti Abbey to contact any of the people listed above to support this application. I give Sravasti Abbey permission to do a criminal background check with state and federal agencies, using information on this application, to the extent permitted by state and federal law. I agree to follow Sravasti Abbey's guidelines, which I have read. I understand that failure to do so may result in termination of my stay at the Abbey. I do not hold Sravasti Abbey responsible for any theft or loss of property or any accident or injury.  
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