Application Form for Workshop at Gotami Vihara. If you wish to participate, please
complete this form. Personal Data. Name/Ordained. Name: .
Application Form for Workshop at Gotami Vihara If you wish to participate, please complete this form Personal Data Name/Ordained Name: ........................................................................................................... Address: ........................................................................................................ Passport/IC number: ......................................................................................................... Occupation: Email address: ................................................................................................ Telephone number: H/P: .................................... Home:................................... Please indicate if you need to stay-in:
Yes/No
If ‘Yes,’ Arrival date: ...................................................................................... Departure Date: .............................................................................................. If Monastic, Ordination Details Ordination Status: ........................................................................................... Year of Ordination: .......................................................................................... Ordination Tradition: ....................................................................................................... Do you have special needs?:
Yes/No
If yes, please specify so that we can take special care: ......................................... ..................................................................................................................... Food Preference: Vegetarian/Non Vegetarian Any allergies: .................................................................................................. Others (Please specify) ....................................................................................
Optional Information Qualifications: ..................................................................................................................... ..................................................................................................................... ..................................................................................................................... Skills/Experience/Strengths: ..................................................................................................................... ..................................................................................................................... .................................................................................................................... Any other Information (Please specify) .................................................................................................................... ..................................................................................................................... ..................................................................................................................... Name of Applicant: ................................................................. Date: ................................................................. To register for the Workshop, please email the application form to: Sis Marie Tungka at
[email protected] or
[email protected].
