Asia-Pacific Core Sangha Retreat
December 25th 2017 – January 01st 2018 at Thai Plum Village International Practice Center, Pak Chong, Thailand

1. Fill out the online registration form.

2. After the registration, a "Confirmation of Online Registration" e-mail will be sent to you. Please check your e-mail.

3. Please make payment and e-mail the payment receipt with the on-line registration confirmation number on it to us, according to the instructions given in the e-mail. Your spaces will be released to the waiting list pool if your bank-in slip is not received within one week.

4. After payments are verified, a "Confirmation of Admittance to Retreat" will be sent to you. Please e-mail us if you do not receive this e-mail 5 days after making the payment.

First name *
Your answer
Last name *
Your answer
Gender *
Your birthday *
dd/mm/yyyy. For example: 26/04/1980
Your answer
Age *
Your answer
Passport Number *
Your answer
Your address (street address, village/town/city/country) *
Your answer
Your country *
* Lưu ý: Mẫu đăng ký này không dành cho người Việt, số lượng người Việt đăng ký đã đủ cho nên không nhận thêm nữa. Nếu các bạn người Việt đăng ký vào mẫu đăng ký thì sẽ không được nhận vào danh sách. Xin thành thật cáo lỗi.
Cellphone Number *
Your answer
E-mail Address *
Your answer
Do you have any medical problems? *
If so, please state them clearly
Your answer
Translation language needed *
This is an English speaking retreat, if you need translation from English into your first language, please choose the below available languages
Have you attended Plum Village events (retreats, Days Of Mindfulness) before? *
How to get to Thai Plum Village from airport? *
Please provide us your flight info so that we can arrange for your airport pickup
Which of the following dates would you like to arrive at Thai Plum Village? *
Which of the following dates would you like to depart from Thai Plum Village? *
In case of emergency, who can we contact with? *
First name and Last name
Your answer
Relationship to you as *
Your answer
Cellphone Number *
Your answer
Email address *
Your answer
I am aware that Plum Village Practice Center is a non-profit organization without any support from any commercial establishments and that the funding is provided solely by the donations from those with kind hearts. Therefore, should I develop any health problems or any personal issues that require treatment during my practice, I am aware that I will be fully responsible for any expenses incurred. *
Required
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