Application Form - The applications of mindfulness - A satipatthana retreat by Patrick Kearney - 10 Aug 2019 - 17 Aug 2019
BANDAR UTAMA BUDDHIST SOCIETY(Reg No. 364)
A Dhamma inspired community in the heart of Petaling Jaya
3 Jalan BU 3/1 Bandar Utama 47800 Petaling Jaya.
Tel No. : 03-77106010/6013 Fax No. : 03-77106012
Web page: http:// www.bubs.my Email: office@bubs.my
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Meditiation Experience *
Type of Meditation *
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Teacher's Name
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Length of longest retreat
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Duration per practice
Sitting
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Purpose of joining this workshop *
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A) Any contagious diseases like TB or advanced diabetic that require constant treatment? *
B) Any health complications, restrictions, physical/psychological disorder that may or will affect you during attending the worksop? *
Accomodation Preferred *
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I hereby declare that the above information is true I am willing to abide by the retreat instructor’s advice and the Society regulations; otherwise I will leave on my own accord. I also understand that the organisers and the retreat instructor shall not be held responsible for any physical or mental injury incurred during or after attending this retreat. *
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