Registration Form 報名表

Language 語言

Gender 性別

First Name 名

Last Name 姓

Chinese Name 中文名, 請以中文填寫

Dharma Name (if applicable) 法名(若適用)

Photo 相片
Please submit a file not larger than 500 kBytes. Acceptable file types are: jpg, jpeg, png, tiff, bmp. If you have any problem uploading photo, please email photo with your name to
請上載個人照片一張,檔案不能大於 500 kBytes。若不能上載,請把照片連同姓名以電郵傳至

Date of Birth 出生日期

Telephone No. 電話

E-mail 電郵


Are you a Master of Dharma Listening Session or a Rinpoche?

Religious affiliation, if not Buddhist (optional) 宗教信仰 (若非佛教徒)

If you have formally taken refuge in either the Three or Four Jewels 已皈依三寶或四寶

Refuge Master 皈依師

Date of Refuge 日期

Refuge Location 地點

Experience in meditation 禪修經驗

Request to meet with Rinpoche individually 是否需要安排仁波且單獨接見

Request to take refuge 祈請皈依

Do you have any food allergies? If you have, which ones? 有沒有食物過敏?若有,請說明。

Emergency Contact 緊急聯絡人

Name 姓名

Telephone No. 電話

Total fees 費用: $400
Early Bird registration before 9/1/2015

All fees include accommodations and meals. It does not include transportation. Participants are required to bring their own meditation cushions. Limited to 30 people. Registration accepted on a first come basis. Upon notification of availability, you will receive payment instructions. Please make payment within 2 days. After 2 days, the reserved space cannot be guaranteed. Payment for registration is non-refundable.  

Fee Policy 收費政策:
Registration fee is non-refundable and participation is non-replaceable.