Bodhi Zendo

Visitor Application Form

Please complete the information requested below.

Contact information

Name:

Email address:

Home address:

General information

Requested length of stay:

Preferred arrival date:

Preferred departure date:

I am a member of Bodhi Sangha: Yes No

If no, please specify the following:

Gender: Male Female Other

Age:
Do you have meditation experience? Yes No
If yes: Please describe the style(s) you have been practicing in:
The last time I sat a multi-day meditation retreat was:

Medical information:
Do you have any physical or psychological health concerns or medical conditions that could
impact your stay at Bodhi Zendo?
Yes No
If yes, please describe:
Do you have questions or comments?

Dietary restrictions:
Please be aware that Bodhi Zendo serves three South Indian vegetarian meals each day. We are
unable to prepare foods to meet special dietary requirements. However, you are permitted to
bring your own dietary supplements that do not require cooking facilities.
Thank you for your understanding, The Bodhi Zendo Office