Taiwan Dipa Pa Auk Meditation Retreat Application Form(Samanasukhavana Forest Monastery and Meditation Center( Taiwan) )
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Personal Data
Name
Answer1 *
Birth of date
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Gender
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Education
Answer4
Marital Status
Answer5
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Nationality
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National ID / Passport No.
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Visa Expiry Date ( for foreigner only )
Answer8
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Status
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Occupation
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Address
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Land Phone
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Hand Phone
Answer13 *
Email
Email *
Language
Answer15
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For  Bhikkhu and Sīla-shin
Dhamma Name
Answer16
Date of Samanena or Sīla-shin ordination
Answer17
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DD
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Date of Bhikkhu  Ordination
Answer18
MM
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DD
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YYYY
Place of Ordination
Answer19
Upajjhaya’s Name
Answer20
Meditation retreat ( Arrival Date)
Answer21 *
MM
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DD
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YYYY
Arrival  time
Answer22
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Meditation retreat (Leaving Date)
Answer23 *
MM
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DD
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YYYY
How would you like to receive reply letter ?
Answer24 *
Health status
Chronic diseases ( if any )
Answer25
Religion
Answer26
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If Buddhism
Answer27
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1. What experience do you have of  meditation in Theravada tradition ?
Answer28
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Place
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Date
Answer30
Duration
Answer31
Teacher
Answer32
2. Do you practise any other kind of meditation  If so what kind and for how long have you practised ?
Answer33
3.Have you had experience of Pa Auk meditation method ?
Answer34
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Place
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Date
Answer36
Duration
Answer37
Teacher
Answer38
4. Do you have any experience of study of Buddhism in Theravada countries ?
Answer39
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Which countries ?
Answer40
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Name of Temple / School
Answer41
In case of emergency  please contact
Name
Answer42
relationship
Answer43
Address
Answer44
Phone No.
Answer45
Submit
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