Compassionate Wisdom for Our Times

Compassionate Wisdom for Our Times

A Mindfulness Retreat

with dharma teacher joannefriday

june 1-4, 2017, won dharma center, claverack, new york

Registration Form

Dear Friend,

We are so happy that you are planning to join us for [title], a mindfulness retreat in the tradition of Zen Master ThichNhatHanh with dharma teacher Joanne Friday. Please complete both pages and return this registration form to us by email () or by snail mail (??).

Name (please type or print clearly):

______

Room Request**:

single ($620) double ($400)  quad ($295)  commuter/camper ($180)

[if double or quad, please indicate if you identify as ____male or ____ female]

Roommate request(s):

______

All beds are single beds (no bunk beds).

Shared bathrooms are available in the halls, close to the rooms.

payment by check only; please make your check payable and mail to:

Berkshire Mountain Laurel Sangha

P.O. Box 33, Monterey, MA 01245

Retreat Registration Form:

Additional Information

** Room rates are set by Won Dharma Center, and include all meals from Thursday dinner through Sunday lunch. No additional fees have been added to these amounts.

Won Dharma Center will make every effort to accommodate special dietary needs; we will contact you if they are unable to honor your request. There is a special refrigerator in the dining hall for those who need to bring their own food. Please indicate any special dietary needs below:

veganGluten-freesoy-free

I have the following food allergy(s): ______

This is my first retreat in the ThichNhatHanh (Plum Village tradition):

yesno

My previous experience with meditation is (note – no experience necessary!):

 none books/on my own

 retreats in other traditions  local sangha practice

I have received the Five Mindfulness Trainings: yes no

I am a member of the Order of Interbeing: yes no

(if yes) my True Name is: ______

I am applying for a partial scholarship: yes no

If yes, please include your scholarship application with this registration form. There is no need to send payment until you receive a response to your application.

For additional questions and concerns, please contact us at ~