Metta : MEDITATION & INQUIRY - Bay Area Residential Retreat with Frank Ostaseski

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MEDITATION & INQUIRY - Bay Area Residential Retreat with Frank Ostaseski

Online Application Form
Meditation & Inquiry Retreat
July 6-10, 2011

Application Process
Please answer all questions on this online form or you application will not be processed. When the application is complete click Submit at the end of the form.

Your application will be reviewed by Frank and you will be notified by email regarding your acceptance into the retreat. Details about making payments will be included in that email. If accepted you will be ask to pay full tuition immediately to secure your place in the retreat.

Please complete all information.

Personal Contact Information

First Name
Last Name
Home Street Address
City
State
Zip Code
e-mail
Home Telephone
Mobile Telephone
Gender
Age
Emergency Contact
Emergency Contact Person Telephone

Meditation and Retreat Experience (Check boxes that apply )

Do you currently have a regular meditation practice?
Yes No
Briefly describe:

How often do you meditate?
Daily
3-5 times per week
Occasionally
Never

What is your meditation retreat experience?
First Meditation Retreat
Completed 2-3 day Meditation Retreat.
Completed 7 day or longer Meditation Retreat.

What is your previous training experience with Frank Ostaseski?
No previous experience
Attended 2-day workshop
Attended 3-7 day Meditation Retreat
Attended longer training
Comments:

Health Concerns

(If you prefer to discuss this by phone, please let us know.)
Do you have any significant physical health concerns or medical conditions that could impact your participation?
Yes No
If Yes, please describe:

Do you have, or do have you ever had, any mental health concerns such as depression, anxiety, addictions, or other psychiatric conditions?
Yes No
If yes, please describe

Logistics

Accomodations:
Most participants will be accommodated in dormitory style rooms. There are a limited number of double rooms reserved for those with sleep disorders or special needs.

Preferred Occupancy: (Check boxes that apply)
I'm comfortable sleeping in a dormitory style room
I am requesting a double room (Note: We cannot guarantee this type of accommodation. These rooms will be assigned by the Retreat Managers.)
Please describe why you are requesting this type of accomodation

Dietary Restrictions: (check all that apply)
None
Vegetarian
No Dairy
No Wheat
Other (specify)

I can attend the entire retreat (Wednesday, July 6 2011 at 5:00 p.m. to Sunday, July 10 , 2011 at 1:00 p.m.) and promise to pay in full.

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