Male 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? Please type in "YES" or "NO".

If "NO", please provide details separately, or discuss with senior monk personally.

Have you ever had, or are currently receiving treatment, or used medication, for any psychological or psychiatric condition? Please type in 'Yes' or 'No'

If "YES", Please provide details separately, or discuss with senior monk personally.

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

Check In Date

Check Out Date

I understand that length of stay can not be determined definitely beforehand, but will depend on mutual agreement how well guest is settling in.

I am committed to the requested dates, and understand that it is difficult for Dhammagiri to accommodate short term changes

I understand that short term cancellation may negatively effect my opportunities for future bookings

I have read and understood the 'Guidelines for Male Guests' on Dhammagiri's website. I agree with conditions as described, and to observe the guidelines during my stay

Date

Your Signature

You will receive an email acknowledging your application.

DHAMMAGIRI FOREST HERMITAGE
Buddhist Meditation / Almsoffering / Dhammatalks / Retreats

Looking forward to seeing you at Dhammagiri.
May all beings be happy and at ease!

DHAMMAGIRI FOREST HERMITAGE Buddhist Meditation / Almsoffering / Dhammatalks / Retreats

Looking forward to seeing you at Dhammagiri. May all beings be happy and at ease!

DHAMMAGIRI FOREST HERMITAGE
Buddhist Meditation / Almsoffering / Dhammatalks / Retreats

Looking forward to seeing you at Dhammagiri.
May all beings be happy and at ease!