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Vipassāna 7 days course: 13 - 19, Jul 2024
* * Applicants need to have prior experience in meditation practice, have to live in Thailand and have been vaccinated. * *
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Check here if you are driving and willing to be contacted by other students seeking a ride to the course
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Will a friend or family member be taking this course as well?
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Have you had any previous experience with meditation techniques, therapies or healing practices?
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How did you learn about Vipassana, or who introduced you to this course?
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Have you practiced any other meditation techniques (including other types of Vipassana), therapies or healing techniques?
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Have you maintained your practice of Vipassana meditation since your last course?
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Check here if you can come early to help set-up if needed.
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Check here if you would be willing to serve this course should the need arise.
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If you are not attending the entire course, please give your arrival date and hour: and departure date and hour
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Do you have any physical health problems, medical conditions or diseases?
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Do you have, or have you ever had, any mental health problems such as significant depression or anxiety, panic attacks, manic depression, schizophrenia, etc.?
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Are you now taking, or have you taken within the past two years, any alcohol or drugs (such as marijuana, amphetamines, barbiturates, cocaine, heroin, or other intoxicants)?
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Are you now taking, or have you taken within the past two years, any prescribed medication?
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Name of the person referred to in case the event that Sickness or unexpected occurrences
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Phone number The person you refer to
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I acknowledge that I have carefully read and understood the booklet Vipassana Meditation, Introduction to the Technique and Code of Discipline for Meditation Courses. I agree to stay on the course site and to abide by all the rules and regulations for the duration of the course. I realize that a Vipassana meditation course is a serious undertaking that will require my full mental and physical health and I affirm that I am fit to participate in it. I hereby certify that the above information is true to the best of my knowledge
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