Female Guest Application Form

First Name

Last Name

Phone

Date of Birth

Address

Next of Kin Contact Details

Are you a Buddhist? If so which Tradition/Teacher.

Have you stayed in Buddhist Monasteries, or participated in Meditation Retreats? If so, please provide details (teacher, length of stay etc).

Why did you feel inspired to choose Dhammagiri as a place to do a retreat?

Are you in good physical health, able to live in the Australian bush in simple physical conditions? Type in "YES" or "NO". If "NO", please provide details separately.

Have you ever had, or are currently receiving treatment, or used medication, for any psychological or psychiatric condition? Type in "YES" or "NO". If "YES", Please provide details separately.

Have you organised a co-retreatant?

What dates would you like to book for your stay at Dhammagiri? Check In / Check Out time is 10:00am to 12:00noon

Check In Date

Check Out Date

Length of stay can not be determined definitely beforehand, but will depend on mutual agreement how well guest is settling in. Please consider if you really can commit to the requested dates, as it may be difficult for Dhammagiri to accommodate short notice changes or cancellations of bookings. Short notice cancellations may negatively affect opportunities for future bookings.

I have read the 'Guidelines for Female Guests', and agree to observe them during my stay at Dhammagiri. Type in "YES" to indicate you have read and agree to the above.

Date

Your Signature

DHAMMAGIRI FOREST HERMITAGE Buddhist Meditation / Almsoffering / Dhammatalks / Retreats

Female Guest Application Form

DHAMMAGIRI FOREST HERMITAGE
Buddhist Meditation / Almsoffering / Dhammatalks / Retreats