Ajahn Brahm’s 2-Day Non-Residential Retreat: “Compassionately Mindful”

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Have you attended a Buddhist meditation retreat before? If yes, please give details. *

Have you been to a retreat organised by Anukampa Bhikkhuni Project before? * Select ... Yes No

Do you have a regular home meditation practice? If yes, please describe. *

Do you have any physical condition that may be aggravated by sitting and walking meditation ? Please describe: *

Have you ever been diagnosed or treated for a psychological condition? If yes, please describe the condition, treatment and dates: *

Are you currently taking any medication for any physical or psychological condition? If yes, please specify the condition and list medications and dosage: *

Are there any particular issues you are working through currently eg depression, anxiety, or bereavement? *

Have you ever attempted to take your own life? If yes please provide dates and details. *

Do you have any dietary or other requirements, such as disabled access? *

Have you ever been asked to leave a retreat? * Select ... Yes No

Please also note that this retreat will be held in silence, apart from Q&A sessions. Are you willing to commit to keeping silence for the duration of the retreat? * Select ... Yes I'm willing to commit to keeping silence during the retreat.

What do you hope to gain from this retreat? *

Please provide the name of the person we should contact in case of an emergency, and include their relationship to you, and their contact details. *

Please confirm that you agree that in the event of having a positive Covid test at the retreat centre, you could be asked to leave the venue immediately, therefore you need to plan for your own transport and or accommodation etc. * Select ... No Yes, I agree

For the Waiting List applicants: Are you able to join the retreat on a short notice? Please give us detailed information on your availability.

Thank you for filling in this form! We will contact you after we have reviewed your application and at that time your registration fee will be due. We will then send you your confirmation. Please note that the registration fee is NON REFUNDABLE. * Select ... Yes I agree

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