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Seven-day Bendoho Zen Retreats
Application Form

Personal details

Student status
Gender

Arrival and departure

Arrival time
access_time
Departure time
access_time
I can offer someone a lift
I will be taking the airport shuttle bus and need transport from Creswick to Adekatepick one!

Retreat attendance

Samu (work practice) is an integral part of the retreat and participants are assigned to a Ryo (work group).

Ryo preference for this retreatpick one!
Are you trained in First Aid?pick one!
Do you have your own oryoki set?pick one!

Health

Are you a snorer
Do you have any medical conditions that may affect your participation

Emergency contact details

**local only
Declaration
Please checkpick one!
My deposit fee of $65 will be paid the following way

Jikishoan Zen Buddhist Community

PO Box 196 Heidelberg West VIC 3081 AUSTRALIA

Phone: 03 8307 0600 | email: contact@jikishoan.org.au

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