Before filling out this registration form please make sure that you have carefully read all the information regarding our Vajrasattva Retreat (pre-requisites, retreat schedule, etc.)

PERSONAL INFORMATION

 

Full name

 

Email address

 

Confirm email address (please check carefully!)

 

Nationality

 

Country of current residence

 

Year of birth

 

Gender

Male
Female

 

Are you an ordained monk or nun?

Yes
No

 

MENTAL & PHYSICAL HEALTH

 

Have you lately / presently been experiencing severe emotional stress or depression?

Yes
No

 

If yes, do you feel stable and relaxed enough to participate on this course, given that we cannot provide one-on-one counselling? Please give details.

 

Are you presently taking any medication?

Yes
No

 

If yes, what for?

 

Have you ever been in psychiatric care?

Yes
No

 

If so when?

 

RETREAT INFORMATION & DISCIPLINE

 

Have you read all the information on our website about the retreat carefully?

Yes

 

Do you agree to attend all sessions of the retreat and keep the discipline of the retreat (including keeping silence, not leaving Tushita until the retreat ends)?

Yes

 

PREVIOUS EXPERIENCE

 

How many years have you been studying and practicing Buddhism? In which tradition?

 

Have you taken Refuge in the Buddha, Dharma, Sangha? When ?

Yes
No

 

If yes, when?

 

What Course (Lam Rim) experience do you have? * A one-month Kopan course? * A 10-day Intro course at Tushita or Kopan? * Others? Please explain

 

Have you taken the Bodhisattva Vows?

Yes
No

 

If yes, when?

 

Have you taken the Eight Mahayana Precepts before?

Yes
No

 

Have you ever done a strict practice retreat before (i.e. doing 4 sessions of PRACTICE each day—this does NOT include courses)?

Yes
No

 

If yes, please describe your retreat experience.

 

Have you received the Vajrasattva Initiation?

Yes
No

 

If yes, at which level (Kriya or Highest Yoga Tantra) ? With or without consort?

Kriya
Highest Yoga Tantra

 

If no, have you taken other tantric initiations before? Which ones?

 

Have you been advised by a lama / close teacher to do this particular retreat?

Yes
No

 

If yes, specify your teacher's name

 

Do you have a commitment to fulfill concerning this practice?

Yes
No

 

If yes, specify the commitment

 

Why do you want to do this retreat?

 

COMMENTS

 

Please enter the black letters you see in the white box (case sensitive):   

 

 

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