Online registration for this event is open!
Welcome to the registration for the 2014 Dzogchen Lineage Internship, led by His Eminence Dzogchen Khenpo Choga Rinpoche!

All participants in this program must attend the opening ceremony. Please plan to arrive at the DRC no later than 3 PM on the first day of the retreat. You cannot enter the retreat after that without the Internship Director's written permission. To attend the full retreat, please plan to attend every session, ending 3 PM on the last day of your retreat.

When making your transportation plans, if possible, please schedule to arrive a day or more early and stay an extra day or more at the end to help prepare the retreat center and clean-up after the retreat. Interns pay only $10 per day for those extra days of retreat.

If other members of your family or circle of friends plan to attend, each person should fill-out and submit this application as soon as possible. Your privacy is important to us. This information will not be conveyed to any third party outside of the Dzogchen Shri Singha organizations.
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Retreat Option *
Please choose which duration you plan to attend. Prerequisites apply.
Discounts
If you qualify for one of the discounts, please indicate below. Note that discounts cannot be combined.
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Age Group *
Select Your Age Group.
First Name *
Your personal name.
Last Name *
Your family name.
Street *
Street address or post office box.
Unit
Apartment, suite or unit number.
City *
Or town.
State *
Or province.
ZIP *
Or postal code.
Country *
Or nation.
Email *
Phone *
Please enter your cell or another telephone number where we can reach or leave messages for you prior to the retreat.
Family Contact
Provide the name of at least one family member or friend who won't be attending the retreat, along with their phone numbers, in case of emergency.
Refuge Vows *
Have you taken Refuge Vows with an authorized Buddhist teacher?
Refuge Vows Teacher
If you answered "Yes" to the question above, please enter the name of the Buddhist teacher who gave you Refuge Vows.
Refuge Name
If you've taken Refuge Vows, please enter your refuge name.
About the Medical Questions that Follow

For the safety of yourself and others, and in case of medical emergency, please respond to the following important health questions.

The retreat organizers aspire to maintain a healthy and safe environment for all retreatants. However, each individual is responsible for his or her health care during the retreat. This includes having an adequate supply of prescription medications, using them as prescribed and immediately reporting to the retreat director any health issues as they arise during the retreat.

Any misuse of prescription or over-the-counter drugs, or any possession or use of illicit drugs, alcohol or tobacco will not be tolerated. There is no smoking anywhere on the property. Violators will be dismissed immediately.

The information gathered in the three questions below will be kept confidential and will only be used to provide the retreat staff with the knowledge to appropriately respond in the event of an emergency.
Addiction Recovery *
Have you ever been, or are you currently, in recovery or rehabilitation for addiction to alcohol, drugs, or any other substances? If so, list the recovery program type and explain your current status. If you have no addiction issues, please type, "none."
Health Issues *
Do you have any health issues that will require ongoing maintenance or special health care during the retreat, for example related to: life threatening allergies, chronic physical or mental health conditions, heart conditions, blood pressure, thyroid, insulin, wheelchair access, etc. Please briefly explain all significant conditions and ongoing treatments. If you have no health issues, please type, "none."
Medications *
Please indicate if you currently on any prescription medications, and if so, list the medications. If you are taking no medications, please type, "none."
Physician Contact
Please list your primary physician's name and phone numbers in case of a medical emergency.
Internships *
Choose from the list the total number of Dzogchen Lineage Internships from which you have graduated.
Internships Attended
Please check each of the Dzogchen Lineage Internships you completed and were awarded a certificate.
Other Retreats Attended
If you have not graduated from an Internship, then please list all of the retreats you attended that were guided by Dzogchen Khenpo Choga Rinpoche. You may also list other retreats you've attended.
Certainty *
How certain are you that you will attend this retreat?
Special Conditions
Describe any other special needs you have or make a note of any conditions or comments you’d like the organizers to read.
How Learned?
Please let us know all the ways you learned of this retreat (for example: via an email newsletter, announcement at Buddha Path Practice, saw an online ad, found out through a web search, etc.).
Pledge
Please consider contributing to the Retreat Fund that will make possible purchase of special supplies for the retreat and scholarships to pay the retreat fees for people in need. Your contribution will generate great merit for you and help accomplish our goal of decreasing and eliminating negativity for the benefit of all beings.  Please enter the $ U.S. dollar amount you wish to pledge. Please include this donation when you pay your retreat fees. Retreat fee payments are not tax deductible, but your donation to this fund is tax deductible to the full extent of the law:
Volunteer
A focused "Volunteer Days" program will be conducted during the days and weeks leading up to the Internship. You are invited to come volunteer for one or more days to help with the numerous projects we'd like to complete before the Internship starts. Our volunteers make a donation of $20 per person per day to help cover their share of food and utilities. You should plan to participate in morning and evening group practices. If you are able to volunteer, please describe your availability and the skills you can provide.
Questions
If you have any other questions or comments for the Internship Director, you may enter them below and we will respond to them on the registration web site. We may also contact you by phone or email to answer any urgent or private questions. The organizers are unpaid volunteers, so your patience with us is much appreciated!
Birthday *
In particular, if your birthday falls during this event, please let us know the month and day so that we do something to acknowledge your special day. You don't need to enter the year you were born.
Agreement *
Please indicate if you have read the Dzogchen Lineage Internship "Retreat Overview" page and agree with the all policies stated there:  http://www.dzogchenlineage.org/internship
Please click the "Submit" button below to send us your application.
Carefully review your answers above, make a note your total fees due adding any pledge you may have made, and then click the "Submit" button below to record your registration and be taken to the Payment Options page.
May all beings benefit!
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