Visit Application Form (continued)
Please enter your answers and return by email to with your namein thesubject line, or print out and return by post: Sravasti Abbey, 692 Country Lane, Newport, WA 99156
This application is to be completed in full by anyone who wishes to stay for five days or longer at the Abbey to attend a program, offer service, or live with the community.
Name:
Address: Street:
City:
State, Zip code:
Country (if not USA):
Telephone:
Email:
Sex:
Birth date (Mo/Day/Yr):
Marital Status:
Number and ages of children:
Driver’s License or Passport number:
What program/retreat/event are you applying for?
What are your proposed dates of arrival and departure:
If you are interested in long-term residency, please read “Joining the Community” under Monastic Life” at How long would you like to stay at the Abbey? What are your proposed dates of arrival and departure?
Person to contact in case of emergency:
Name:
Phone:
Email:
Address (street, city, state, zip code):
Relationship:
Since you are applying to stay at the Abbey, which is the home of monastics, we will ask you some personal questions to get to know you better. This information is also useful in helping you progress along the path more effectively. All information will be kept confidential and will be shared only in case of emergency. Thank you for answering all the questions with clarity.
- How long have you been actively studying and practicing Buddhadharma?
- Please tell us about your Buddhist studies.
- Do you have a teacher? If so, whom? How long have you studied and practiced under this person’s guidance?
- Do you do a daily meditation practice? If so, what meditation(s) do you do? Add any other information about your religious/spiritual background that could be helpful.
- Have you done any meditation retreats or long courses? Please describe.
- Have you received the five lay precepts? Monastic precepts? Bodhisattva precepts? Who did you receive the lay and/or monastic precepts from?
- Why would you like to attend this program? Or, if you’re applying to stay at the Abbey, why you would like to live with our community?
- What is your educational background? What have you studied and at which schools? What degrees have you received?
- How do/did you earn your living?
- What skills do you have that you would like to offer to the community during the periods of offering service (for example, building, electrical, plumbing, gardening, maintenance, cooking, transcribing, editing, computer, fund raising, graphic designing, office, etc.)?
- The daily schedule (except for retreat times) is:
5:00 am
5:30-7:00
7:00-7:30
7:30-8:00
8:30-noon
Noon-12:45 / Wake up
Meditation Practice
Breakfast Prep
Breakfast (in silence)
Offering Service
Lunch (in silence) / 2:00-4:30 pm
4:30-6:00
6:00-7:00
7:00-8:30
8:30-10:30 / Offering Service
Study time Medicine Meal andclean-up (in silence) Meditation
Personal meditation & study
Are you willing and able to participate fully in our daily schedule?
The next several questions need to be answered with as much detail as possible. Complete responses enable us to understand and appreciate the conditions that could impact your safety, health, and ability to live here with others. Answering yes to any of these questions does not exclude you from joining us.
- Do you have a chronic illness or injury? If so, please describe.
- Do you have physical limitations that may interfere with or might be aggravated by sitting practice or by offering service while at the Abbey? If so, please describe.
- Please list all medications that you take (prescription and over the counter) and the medical conditions they are treating.
15. Are you allergic to: any medications, drugs, insect bites, foods?
16. What medicines do you use if you have an allergic reaction?
17. Do you snore such that it could disturb a roommate?
18. Do you have health insurance? If so, please give details (insurer, id number). Please give the name and contact information of your physician.
19. Have you ever had or been treated for a psychological condition such as depression, eating disorder, drug/alcohol addiction, anxiety disorder, psychosis, schizophrenia, bipolar, or any other psychological conditions: Please specify condition(s) , dates(s), and treatment (including medicine) you received:
20. Have you ever spent time in a mental health institution or drug/alcohol rehabilitation centre (inpatient or outpatient)? When? If so, please describe.
21. Please describe your experience with psychotherapy, if any. Are you currently seeing a therapist or counselor?
22. Do you currently use alcohol, recreational drugs, or tobacco on a regular basis?
If so, are you prepared to abstain from using them for the duration of your stay?
23. Are there conditions in your life that might be placing you under stress or that could make living at the Abbey challenging? (e.g. divorce proceedings, debt, substance abuse withdrawal, loss of a loved one, etc.)
24. Have you ever been convicted of a crime? If so, please describe.
25. Please describe your experience, if any, in the areas of the healing arts, channeling, rebirthing, occult practices, etc.
26. Please list two references (not relatives). One should be a recent employment supervisor.
Name:
Phone:
Email:
Address (street, city, state, zip, and country):
Relationship:
How long has this person known you?
Name:
Phone:
Email:
Address (street, city, state, zip, and country):
Relationship:
How long has this person known you?
27. Safety Net. Please list a person who will be your “safety net,” a person who will provide for you should you need to leave Sravasti Abbey for any reason. If it is one of your personal references, just list the name.
Name:
Phone:
Email:
Address (street, city, state, zip, and country):
Relationship:
How long has this person known you?
28. Have you read the guidelines for staying at the Abbey and do you agree to follow them?
29. Do you have any concerns about staying at the Abbey? If so, please tell us….
If you are a monastic, please fill out all of the above questions and those that follow.
28. Please tell us the level of ordination (lay precepts, 8 precepts, sramanera/sramanerika, shiksamana, bhikshu/bhikshuni), when you received that ordination, and who was your ordaining master.
29. Who is your principal teacher?
30. What are the principal reasons that led you to become a monastic?
31. Where have you been living since ordination? Which Dharma centers, temples, or monasteries have you resided at? For how long? What were the reasons you left?
32. Please give a reference from one of the monasteries or Dharma centers where you stayed.
33. From where do you receive your material support?
34. What about monastic life gives you the most joy?
35. What about monastic life do you find most difficult?
36. What kind of help or support in your practice would you like?
Everything on this application is true and complete to the best of my knowledge. I authorize Sravasti Abbey to contact any of the people listed above to support this application. I give Sravasti Abbey permission to do a criminal background check with state and federal agencies, using information on this application, to the extent permitted by state and federal law. I agree to follow Sravasti Abbey’s guidelines, which I have read. I understand that failure to do so may result in termination of my stay at the Abbey. I do not hold Sravasti Abbey responsible for any theft or loss of property or any accident or injury.
Signature:
Date:
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