SHENPEN INTERNATIONAL
Thank you for taking an interest in the teachings of His Eminence the 7th Dzogchen Rinpoche, Jigme Losel Wangpo. Dzogchen Rinpoche is the holder of the 400-year-old lineage of Dzogchen and due to the precious nature of these teachings, it is important for Rinpoche to have a clear view of your spiritual history.
Please complete all sections of this application form before submitting.
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Please select the event you would like to attend (only select one)
Friday 8th November (arrival day) to Monday 18th November 2024
Clear Mind Dzogchen Centre, Victoria
AU$ 2300 (Concession AU$ 2100)
contact: dzogchenretreat@shenpenaustralia.org
Tuesday 5th November (arrival day) to Monday 18th November 2024
Drupa Na Sel: Tuesday 5th November (arrival day) to Thursday 7th November 2024
Retreat: Saturday 9th November to Monday 18th November 2024
CMDC Australia, Victoria
AU$ 2940 (Concession AU$ 2700)
Is this your first Retreat / Seminar with H.E. Dzogchen Rinpoche? No Yes
If this is your first Retreat / Seminar with H.E. Dzogchen Rinpoche, you will need to upload a photo. Please upload a standard passport photo of yourself. The file must be one of the following formats - jpg, jpeg, gif or png. The file must not be larger than 250kbs.
File to upload:
Do you follow any spiritual tradition or lineage? If so, since when?
Are you presently doing any spiritual practices? If so, which?
When did you first connect to H.E. Dzogchen Rinpoche and how or through whom did you make the connection?
How did you hear about this retreat / seminar?
Publicity Email Facebook Dzogchen Monastery / Shenpen website Poster / flyer Magazine / newspaper Word of mouth Other :
Why would you like to attend?
The following information is helpful for the Seminar Coordinators to know in case of a medical situation:
Do you have any health conditions that might come up during your participation?
1. Allergies? No Yes
If yes, please specify:
2. Cardiovascular / cardiac condition? No Yes
3. Respiratory condition? No Yes
4. Psychiatric or neurological illness? No Yes
5. Other past or current illnesses? No Yes
6. Do you have any special needs that you would like us to know about? No Yes
All information given by you on this application form is regarded as strictly private and confidential within Shenpen International and will not be distributed to any other persons or organisations.
We advise that you take out medical and any other relevant insurance for the duration of the retreat/seminar. Any medication prescribed by your doctor should be continued as prescribed throughout the retreat/seminar. Applicants with a past history of psychiatric illness or chronic illness, who have received or are receiving psychiatric or medical treatment at present, are required to consult their psychiatrist or doctor and obtain medical clearance prior to applying. Shenpen International cannot accept responsibility for personal accidents, injuries, illnesses, exacerbation of existing medical conditions or loss/damage to your personal property during these events.
I would like to receive emails regarding the activities of H.E. Dzogchen Rinpoche and Shenpen. (OPTIONAL)
I have understood the above and confirm that all information provided on this form is true and correct.