LWM Retreat Center Application
LWM Retreat Center Work Study Program
* Required
First Name
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Your answer
Middle Name
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Your answer
Last Name
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Your answer
Age
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Your answer
Ethnics
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Choose
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White
Email
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Your answer
Phone Number
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Your answer
Address
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Your answer
City
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Your answer
Emergency Contact Name, Relationship and Phone
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Your answer
Start Date
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MM
/
DD
/
YYYY
Preferred Duration
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Your answer
Select all types you are willing to stay:
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Private canvas yurt tent with bed
Dorm in Large Trailer (own room or shared)
Dorm in Small retreat hut (shared)
I have my own trailer, RV or camper van
Other:
Required
If you have your own trailer, RV or van, what type and how long is it?
Your answer
How are you coming here?
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Drive myself
By flight
By train or bus
Have you done meditation and what kind of meditation? How long have you been doing it?
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Your answer
Have you learned Buddhism and what tradition or topics have you learned?
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Your answer
Have you been to any meditation centers in US or Asia, follow the teachings of any teachers?
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Your answer
Education Degree
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High School
AA
Bachelor
Master
Doctoral
Other:
Education Major
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Your answer
Jobs (current and/or previous)
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Your answer
Are you currently working?
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Choose
Full time
Part time
Not working
What skills do you have?
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Your answer
Do you have any mental illness like depression, post traumatic stress disorder (PTSD), bipolar disorder etc? Do you may need help on any of these?
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Your answer
Is there anything else you want to add to your application?
*
Your answer
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