2020 Fall Intensive Application (Exp)
(you might have to scroll down both within the form and outside of the form to get to the very end)
Full Name *
Cell Phone Number *
Email Address *
Home Mailing Address *
Age *
What is your racial identity? *
What is your sexual orientation? *
Do you identify as disabled or do you live with a disability? *
Previous and Current Occupations or Retired From *
What was the last 7-day (or longer) residential retreat meditation you attended? *
What are your top three motivations for taking this current Intensive? *
What experience do you have with mindfulness, insight and metta meditation? *
What are your current daily or weekly spiritual/meditation practices? *
Have you experienced prolonged mental distress or mental illness in the past 3 years? If yes, please briefly describe. *
What are the areas in your current life where you find your greater challenges to be mindfully present or kind to yourself or others? *
Indicate any reasons you might miss a class or a daylong (travel or obligations): *
Please indicate the upper amount you can afford for the program. If you cannot offer the full $950, describe your financial circumstances. *
Signature (by typing your name here you are agreeing to follow the full program): *
Please email <tempeldpp [at] gmail.com> with a digital current picture of yourself and say you have filled out this form.
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