Application Form for Visiting

Name, phone number, and email of the person we should contact in case of an emergency *

Do you have a valid driver's license? *

Yes

No

Note *

I have health insurance applicable in California that will be effective for the duration of my visit.

I am currently covered by travel insurance that will be effective for the duration of my visit.

I don't currently have health insurance, but will obtain health insurance that will be effective for the duration of my visit.

Requested Arrival/ Departure Date (expected time are 8 am - 11 am/ 3pm-5pm) *

From

To

Please fully inform us of any physical and/or mental health conditions that you have or that you may have, how they affect you, and how they are managed (including medications). *

Confirm Email Address *

Gender *

Female

Male

Other*

Phone *

Full Name *

Email *

Check here to receive email updates

Address *

I, the undersigned, declare that I have completed all sections of this form completely and truthfully, and have read and understood the orientation notes. *

Are you a US Citizen? *

Yes

No

Upload Your ID/Driver's license *

If you are a monastic, please provide 1) your birth/layperson's name, 2) your ordination tradition, 3) your ordination date, 4) your level of ordination (anagarika, mae chee, thilashin, novice, bhikkhuni, etc.), and 5) the name of your preceptor and any guiding teachers.

Date of birth *

Have you stayed in a monastery or meditation center before? Please provide details of when and where.

If there's anything else you'd like us to know about you or if you have any other comments or concerns, you can let us know here:

Length of your stay (If you are a first-time visitor, this must be no more than two weeks from your requested arrival.) *

Under what teachers have you studied and practiced? What meditation practices are you familiar with? *

Prior to applying, you must read the orientation notes, which are here.

Apply to Stay overnight