DRBU Summer Program

Application Form

* Denotes a required field

Full Name: *
Age: *
Gender: *	Male Female
Occupation: *
Education: *
Email: *
Phone: *
Address : *
City: *
State:
Zip code:
Country: *
Date arrive: *	(mm/dd/yyyy)
Date leave: *	(mm/dd/yyyy)
TRANSPORTATION We will do our best to help you find a ride, but we cannot guarantee it.
Do you need a ride? *	Yes No
Are you willing to give a ride? *	Yes No
Background
Background in Buddhism/meditation (interest, books read, etc.) *
Are you currently a college student? *	Yes No If yes, what college?
Have you attended any other DRBA events before? *	Yes No
If so, please briefly describe the event and your experience.
Because the Oregon portion of this retreat may involve camping, please describe your experience/familiarity with camping and being outdoor.
How did you hear about this retreat? *
What part of Buddhist teaching do you resonate with the most? *
What attracted you to this retreat? *
EMERGENCY INFORMATION Emergency Contact
Name: *
Phone: *
Address: *
Relation to You: *
Anything Else?
Comments:

If you need financial aid or a scholarship, please fill out the scholarship application (DOC, PDF) and email/fax/mail it to summerprogram@drbu.org / (347) 402-5486 /

DRBU Summer Program
PO Box 217, 2001 Talmage Road,
Talmage, CA 95481-0217