Skip survey header

Retreat Application

Please make sure to fill out all the necessary fields COMPLETELY so that the application can be processed promptly.
1. Personal Details
This question requires a valid date format of MM/DD/YYYY.
calendar
Gender *This question is required.
This question requires a valid email address.
2. Program Details
This question requires a valid date format of MM/DD/YYYY.
calendar
This question requires a valid date format of MM/DD/YYYY.
calendar
This question requires a valid number format.
3. Health
Do you have any health related issues, mental illness or food allergies? *This question is required.
4. EMERGENCY CONTACT
This question requires a valid email address.
5. Kwan Um School of Zen Membership
Are you a current member of a KUSZ center? *This question is required.
6. Practice Record
Precepts & Dates
Space Cell PreceptDateName of Zen Center or TempleTeacher's Name
Bhikku /Bhikkuni /Sami /Samini /None
5P/ DTiT/ DT/ SDT/ BT/ JDPSN/ ZM /None
For Bhikkhu or Bhikkhuni please give the following details:
8. Declaration *This question is required.
This question requires a valid date format of MM/DD/YYYY.
calendar
From time to time, group photos are taken during programs at Musangsa. Do you give permission to Musangsa to allow your photograph to be taken during participation in Musangsa's programs? The photos will only be used to promote Musangsa's activities and will not be used for any other purpose or by a third party. *This question is required.
Do you give Musangsa permission for your email address to be stored in Musangsa's mailing list, so that we may notify you of future programs? Your email address will not be distributed to a third party. *This question is required.
Please submit a recent photo of yourself separately by email to office@musangsa.org with your name and dates for your Kyol Che participation.

Important: This application will be received and approved by the Guiding Teacher before the applicant is admitted to any retreat program. The same applies to former retreat participants.
 
 
MUSANGSA                    T: +82 42 841 6084                    F: +82 42 841 1202                    office@musangsa.org                    www.musangsa.org