Lotsawa Rinchen Zangpo Translator Program Rato Chowar Labrang [email protected] Session Road,Dharamshala http://www.lrztp.org H.P. 176215 INDIA Registration Form Intensive Tibetan for Dharma course 05/09/2016 - 14/10/2016 First name: Last name: Gender: Country: Date of Birth: Email Address: Confirm email address (please check carefully): Phone Number: Phone Number in India: Native Language: Ordained Sangha member: Lotsawa Rinchen Zangpo Translator Program Rato Chowar Labrang [email protected] Session Road,Dharamshala http://www.lrztp.org H.P. 176215 INDIA About yourself Please describe briefly your educational and professional background. ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Please describe briefly your motivation for joining the LRZTP Short course. ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Have you been to India before? ________________________________________________________________________ Lotsawa Rinchen Zangpo Translator Program Rato Chowar Labrang [email protected] Session Road,Dharamshala http://www.lrztp.org H.P. 176215 INDIA Please describe your connection with Tibetan Buddhism (How long have you been practicing? What traditions do you follow? Where did you studied Buddhism? Who are your teachers? etc.) ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Have you studied Tibetan language in the past? (If so, please describe when and where you have taken Tibetan language classes) ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Lotsawa Rinchen Zangpo Translator Program Rato Chowar Labrang [email protected] Session Road,Dharamshala http://www.lrztp.org H.P. 176215 INDIA Physical and Mental health The LRZTP respects your privacy and promise not to publish and/or share your personal physically and mentally health information with anyone but the teacher of the course, LRZTP director and the course manager only. How is your physical health? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Do you have a medical condition which may affect your ability to participate on the course? If yes, please give details. ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Have you lately / presently been experiencing severe emotional stress or depression? ________________________________________________________________________ ________________________________________________________________________ Lotsawa Rinchen Zangpo Translator Program Rato Chowar Labrang [email protected] Session Road,Dharamshala http://www.lrztp.org H.P. 176215 INDIA Do you have any history of serious mental health problems? ________________________________________________________________________ ________________________________________________________________________ If yes to either question, do you feel stable and relaxed enough to participate on this course, given that we cannot provide one-on-one counselling? Please give details. ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Few more things... Do you accept that LRZTP's short course is, above all, a Dharma project, and that students are required to abide by the 5 lay precepts on the premises of the school (refrain from killing, stealing, lying, and sexual misconduct), to refrain from taking intoxicants (or arriving in class having taken intoxicants), and to refrain from any behavior disrespectful and contrary to that of a Dharma practitioner? ________________________________________________________________________ Lotsawa Rinchen Zangpo Translator Program Rato Chowar Labrang [email protected] Session Road,Dharamshala http://www.lrztp.org H.P. 176215 INDIA I have paid the course deposit in the sum of 100$/6500INR and aware that this deposit is nonrefundable and will be reduced from the total course fee payment of 600$/39,000INR. (To the online donation page press here) Sign here: _________________________________________________________ How did you learn about this course? o From a friend o From the Website o From Facebook o From an add/poster o Other: __________________________________________________________________ __________________________________________________________________ Is there anything else you think we should know? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Thank you very much! Looking forward seeing you in the course. .