Kopan Monastery

Lam-rim Retreat

Personal Data * Required fields
Additional Detail
Contact person in case of emergency?
Contact phone for emergency?
Are you planning to have a travel insurance? (we recommend this) Yes   No
Have you read all the information about the course? Yes   No
Are you aware of and accept the course discipline? Yes   No
Do you have any physical health problems? If yes, please give details:
Are you presently taking any medication? If yes, please give details:
Have you lately/presently experienced severe emotional stress or depression? Yes   No
Have you lately/presently experienced mental problems, (such as acute anxiety, paranoia)? Yes   No
Buddhist Background
How long have you been involved in Buddhism?
What lineage are you following?
Have you taken refuge? Yes   No
If yes, who is your refuge teacher?
Previous studies and retreats. Please give details:
Please outline in a few sentences your reason for wanting to attend the retreat (short generic answers such as "for all sentient beings, want to become enlightened for all sentient beings, etc.," are not accepted):
If you do not fulfill these strict requirements, or not all of them, please write briefly why you still feel that the retreat is suitable for you / why you are suitable for the retreat.
Vaccination
Yes
No