Meditation Retreat To Be Conducted by Venerable Aluthgamgoda Gnanaweera Thero
21st to 24th May 2018
Registration of Participants. Closing Date:30th of April 2018.
(Participation Fee of $50.00 to be paid on 21st May 2018)

Please read NOTES on the right before filling the Form.
Primary Applicant may add close family members: spouse and children in Box 8.

Already Registered: 14

Available Positions: 36

Tentative Registration Closing Date:
30th April 2018

(1) Primary Applicant's First Name:
  • Participation Fee of $50.00 to be paid on the first day of meditation, to cover the utility expenses of Mahavihara and the Air Ticket of the teacher.
  • If other family members (spouse or children) are participating please enter the total number against 'Total Participants' in the 6th field and their names,dates and seating preference against 'Participant Names..' in the 8th field.
  • 7th Field: Please select your seating preference: cushion or chair. Chairs will be placed at the back or sides of the Hall.
  • 8th Field: If you attend full meditation period, enter 'Full Period' else enter the relevant dates 22nd, 23rd etc. and seating preference against 'Participant Names..' together with the names of any family members.
  • 9th Field: Please enter Name and Tel.Number of a person to contact in case of an emergency.
  • 10th field: Security Number is to avoid potential for misuse of this form. If it is not clear please refresh page.
  • Thank you for taking time to register.
(2) Primary Applicant's Last Name:
(3) Email:
(4) Telephone:
(5) Full Mailing Address:
(6) Total Participants:  
(7) Seating Preference:  
(8) Participants Names, Dates and Remarks:
Please Enter 'Full Period' or dates of partcipation with names.
(See Notes on the Right)
(9) Emergency Contact Name & Tel.:
(10) Enter Security NumberSecurity Number:⇛ 
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