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Buddha’s Enlightenment (Rohatsu) Sesshin 2019 December 7 @ 7:00 pm - December 13 @ 3:00 pm « Zentensive Five-Day November 2019 Deadline to apply: Saturday 11/23 Please select a sesshinBuddha's Enlightenment (Rohatsu) Sesshin December 7-12, 2019 Full NameAttendanceFull TimePart TimeIf applying to attend part-time, please describe your attendance plan (plans are subject to review/approval).Will you need a chair for zazen?NoPart-TimeFull-TimePlease describe any food allergies or special dietary needs (vegan and gluten free options are always available).Contact InformationEmail PhoneAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Date of BirthEmergency ContactPlease answer the following questions in detail, using the back of this form and additional paper as needed. The purpose of requesting this information is to help determine whether attendance at sesshin might adversely affect an applicant’s health and/or the well-being of others. It also helps those conducting sesshin to be aware of physical and mental conditions that may require special consideration. For this reason it is vital that all health information be current and specific in regard to both active and inactive conditions. This medical information is solely for the reference of teachers and monitors and will be kept confidential. If you would prefer to speak privately with a teacher, this can also be arranged.List any medications you are currently taking and the reasons for their use.List any major surgeries you have had in the past 5 years.Have you ever been institutionalized or incarcerated at any time?NoYesIf yes, please provide detailsDescribe any significant conditions that may affect you or others in sesshin. This would include such things as allergies, current illnesses, snoring, menstrual difficulties, being pregnant, etc.Are you in psychotherapy at this time?YesNoHave you ever seriously contemplated or attempted to take your own life?YesNoIs there anything else related to your past or current life circumstances that would be helpful for us to know about and that might have some bearing on sesshin?NoYesIf you have answered Yes to either of these last questions, please provide details below, and/or set up a time to talk with a teacher directlyPlease also notify us of any medical conditions that may arise after you have submitted this application. If new to Windhorse, please provide details about your Zen practice backgroundSESSHIN COSTS: The prices below include retreat fees as well as room and board for the duration of sesshin. Dana for our teachers and staying extra days before or after are not included. Learn more about staying at Windhorse outside of sesshin The cost of sesshin for dues-paying Windhorse members is $55 per day ($385 for a 7-day sesshin). For non-members, the sesshin price is $60 per day ($420 for a 7-day sesshin). If you are unable to pay the full cost of sesshin, please contact the center directly and apply for a scholarship. For those who are able to contribute more, we ask that you consider paying a “benefactor price” of an additional $100-$200. This portion of your sesshin fee is a tax-deductible donation to the center and it allows Windhorse to offer scholarships to those who cannot afford the full cost of sesshin. *If applying after the deadline, a $5 per day fee will be added to the cost of sesshin. *Please note: These prices do not include dana for our teachers, who are not paid a salary for their Dharma work. Enter Amount You Will Pay Total $0.00 + Google Calendar+ iCal Export Details Start: December 7 @ 7:00 pm End: December 13 @ 3:00 pm Event Categories: Monthly Calendar, Sesshin, Workshop Retreats
