Nirvana Friends Program
Please answer the questions to the best of your abilities. Provide a Phone number / email address, so that we can follow up with you. There are limited spots available for this program and will be considered based on availability.
Legal Name *
Your answer
Sannyas Name (if applicable)
Your answer
Address, Contact Information *
Please provide your current contact information, email and phone.
Your answer
Do you have any medical concerns, allergies, take any medicine or drugs? *
Your answer
Do you or anyone in your family have a history of psychological illness or treatment? *
Your answer
What is your work and financial situation? *
Your answer
What inner area of your life (emotional, psychological) do you want to change ? *
Your answer
What outer area (work, relationships, health) do you want to change? *
Your answer
Have you tried any therapies, growth trainings, etc.? Please list. *
Your answer
What do you like best about yourself? *
Your answer
What do you like least about yourself? *
Your answer
What gives you the most joy? *
Your answer
What gives you the most pain? *
Your answer
What gifts or talents would you like to share with our community? In what way? What are your goals for staying here? How long would you like to stay? *
Your answer
Would you like to experience a silent meditation retreat during your stay? *
Your answer
What is the best way to contact you? *
Required
Elaborate on which activities you would like to do during your stay: (Shopping, Clean Common Areas, Cook, Wash DishesLaundry, Help in the Orchards and Gardens, Others....) *
Required
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