Retreat Application December

What schedule do you plan to follow?
Extended Practice (3 Hours/Day)Deeper Practice (6 Hours/Day)Full Retreat (17 Hours/Day)

If Yes to above, what month and year?

FIRST TIME APPLICANT INFORMATION

Occupation

Date of Birth

PRACTICE HISTORY

The purpose of collecting this information is for the retreat teacher to help guide your practice. Please include as much information as possible below:

Do you attend the meditation at TCC regularly?
YesNo

Have you read anything from Guo Gu, if so what?

Have you taken a meditation class from Tallahassee Chan Center?
YesNo

What meditation method do you use?
Counting breathFollowing breathSamatha and VipassanaSilent IlluminationHua-tou
Other Method:
Have you studied meditation elsewhere?
YesNo

If you have studied with another meditation teacher(s), who have you studied with?

Have you done retreat with that teacher(s)?
YesNo
How long have you studied with that teacher(s)?

How many years have you been practicing meditation?

Do you practice meditation regularly?
DailyWeeklyIrregularlyNever
Date of last retreat (3 days or longer, month & year only)

Why do you want to come on this retreat? Please also include any additional comments about your practice below

Do you plan to stay at the center housing?
YesNo