Application for the Generosity in Action Retreat-New Hamlet, 3 ~ 17 January, 2020

Please only fill this application ONE TIME if you have been to at least one retreat in a Plum Village center before.

Allow us approximately 2 weeks to get back to you about the result of your application.

Email address *

Untitled Title

Have you been in a retreat in a Plum Village center before? *

No (if NO, do not contine)

Yes

Required

Which retreat (s) in which center (s) *

Your answer

First Name *

Your answer

Last Name *

Your answer

Gender *

Female

Male

Required

Date of Birth *

YYYY

First Language *

Your answer

Second language *

Your answer

Your address *

Your answer

Phone number(s) *

Your answer

Your Profession/Occupation *

Your answer

More About You *

I can translate from my first to second language or vice versa

I can drive a manual car or a van

I can drive an automatic car

I am a heath care professional

I am a teacher

Other

Do you have any physical limitations? If yes, please give details *

Your answer

Have you recently, or in the past, suffered from any mental problems or illness? If yes, please give details *

Your answer

If my application is successful, I will commit to respect the rules of life in Plum Village, particularly : *

You must

to respect and practice the Five Mindfulness Trainings that appear on the Plum Village website

not to take substances that alter the mind (i.e. no drinking of alcohol, smoking, or prohibited drugs of any kind)

to practice to live in harmony with the Sangha and open to receive Sangha's constructive feedback regarding my practice.

to understand that the Sangha is not able to accommodate to my special needs or diet.

to fully attend Sangha activities except when I am unwell.

to make sure that I have a valid health insurance for the length of my stay.

Required

I certify that my answers are true and complete to the best of my knowledge. I understand that Plum Village reserves the right to ask me to leave at any time if any concerns are raised about my conduct, such as causing disharmony in the community, or not following the community's guidance... *

Yes

No, I don't agree

Required

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