Dhamma Dena ICD Retreat Registration
Weekend Retreat for the Insight Community of the Desert
City, State, Zip
Phone numbers (list all, indicating cellphone)
Date of birth
Special Dietary Needs
Please note that we will be offering gluten-free options for all meals.
Do you have any special needs for housing, or for your health?
Have you attended a retreat at Dhamma Dena before?
No, I am a new student
Are you new to Vipassana meditation?
Where did you hear about the retreat?
Dhamma Dena mailing list
Online - Dhamma Dena website
Online - other website
Word of mouth/friends
Scholarship/Work Exchange Requested
I am not requesting financial assistance
I would like to apply for a work exchange but can pay something
I am requesting a full scholarship
I'll pay using PayPal on this site
I'll pay by check to Dhamma Dena, P.O. Box 183, Joshua Tree, CA 92252
NOTE: Your registration is not confirmed without a deposit
Send me a copy of my responses.
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